Alzheimer joins Kraepelin

Super Memory Formula

Natural Alzheimer Cure and Treatment

Get Instant Access

In 1903, after 14 years in Frankfurt, Alzheimer left the Frankfurt institution. Emil Kraepelin (Fig. 4), one of the most influential psychiatrists of his time, had offered him a position as scientific assistant at his clinic in Heidelberg. Alzheimer's close friend, Franz Nissl, who had previously also moved to Heidelberg, persuaded Alzheimer to join them. Alzheimer's stay in Heidelberg, however, was to be short. Only six months after he had taken up his new position, in the autumn of 1903, Kraepelin moved to Munich to head the Royal Psychiatric Clinic (Nissl 1916). Alzheimer went with Kraepelin to Munich and took over the clinic's large anatomical laboratory. Under Alzheimer, the laboratory quickly filled with students and guest scientists from various countries

Friedrich Lewy

Fig. 4. Emil Kraepelin. This picture is the frontispiece from Kraepelin's 9th edition of his volume on clinical psychiatry (Leipzig 1927)

(Fig. 5). These included Friedrich H. Lewy, famous today for the Lewy bodies named after him, as well as Hans-Gerhard Creutzfeld and Alfons Maria Jakob, who in the early 1920s would be the first to describe the disease that now bears their names, Creutzfeld-Jakob disease. Also Alzheimer's extensive teaching duties increasingly impinged on his time to do research. Yet despite these new tasks, he never lost interest in the presenile dementias, including his key case of Auguste D.

Sioli had regretted losing Alzheimer, but he promised to keep him up to date on the development of Auguste D. Her physical and psychological state progressively worsened. She became more and more distant, shouting and hitting when being examined. Her speech became completely unintelligible. Later she stopped talking altogether, only humming or shouting wildly, often for hours and without apparent triggers. She ate irregularly, had to be fed and continuously soiled herself. In her final year, she became completely apathetic and spent most of her time hunched up in her bed. In early 1906, she developed pneumonia and on April 8,1906, five weeks short of her 56th birthday, Auguste D. died. In the file describing her case, her cause of death is given as septicaemia due to a decubitus (Maurer et al. 1997).

The case of Auguste D., as recorded by Alzheimer, accurately describes the clinical course of many patients suffering from Alzheimer's disease: her increasingly failing memory, notably her early problems to establish and maintain memories for recent events; her impaired comprehension, unpredictable behavior and psychosocial ineptitude; as well as her disorientation and progressively developing aphasia. Overall, the

Alois Alzheimer

Fig. 5. Alois Alzheimer and guest scientists in his anatomical laboratory at the Royal Psychiatric Clinic in Munich. Top row, left to right: F. Lotmar (Switzerland), unknown, St. Rosental (Poland), Allers (?), unknown, Alois Alzheimer, Nicolás Achúcarro (Spain), Friedrich H. Lewy (Germany). Bottom row, left to right: Adele Grombach (Alzheimer's technician), Ugo Cerletti (Italy), unknown, Francesco Bonfiglio (Italy), Gaetano Perusini (Italy)

Fig. 5. Alois Alzheimer and guest scientists in his anatomical laboratory at the Royal Psychiatric Clinic in Munich. Top row, left to right: F. Lotmar (Switzerland), unknown, St. Rosental (Poland), Allers (?), unknown, Alois Alzheimer, Nicolás Achúcarro (Spain), Friedrich H. Lewy (Germany). Bottom row, left to right: Adele Grombach (Alzheimer's technician), Ugo Cerletti (Italy), unknown, Francesco Bonfiglio (Italy), Gaetano Perusini (Italy)

clinical symptoms displayed by Auguste D. fit well into the range of symptoms associated with Alzheimer's disease today. Furthermore, the examination of her brain was to result in the discovery of the characteristic changes associated with the disease.

Shortly after her death, Sioli sent Auguste D.'s brain to Alzheimer for detailed morphological examination. From this examination, Alzheimer hoped to uncover the histopathological changes responsible for the symptoms he had observed and thus to understand this new and "peculiar" disease. The first anatomical and histological studies confirmed Alzheimer's suspicion that this was an exceptional case and well worth pursuing further. On a gross anatomical level, the brain showed a widespread atrophy. Together with two visiting Italian physicians, Gaetano Perusini and Francesco Bonfiglio, Alzheimer meticulously examined the histological sections of Auguste D.'s brain. The sections again revealed the massive loss of cells that had occurred in various brain regions. But in addition to the atrophy, Alzheimer and his colleagues observed peculiar thick and strongly staining fibrils in the remaining neurons, a discovery made possible in large part by the silver stain recently developed by Max Bielschowsky. They also discovered deposits of an unidentified substance in the form of plaques throughout the cerebral cortex.

The brain of Auguste D. thus displayed what are considered today hallmarks of the brains of patients suffering from Alzheimer's disease: a loss of neurons as well as the accumulation of amyloid plaques and neurofibrillar tangles. For Alzheimer and his colleagues, though, the histological findings in Auguste D.'s brain represented a novel and as yet uncharacterized pathology. To some extent, they were reminiscent of changes in senile dementia, a pathology observed in elderly patients (for a discussion, see Alzheimer 1911 and references therein). What was peculiar about Auguste D.'s case, however, was that the changes occurred in a woman who was only 55 years old when she died and that they were much more profound than those in patients suffering from senile dementia in their 70s or 80s.

Was this article helpful?

0 0
Unraveling Alzheimers Disease

Unraveling Alzheimers Disease

I leave absolutely nothing out! Everything that I learned about Alzheimer’s I share with you. This is the most comprehensive report on Alzheimer’s you will ever read. No stone is left unturned in this comprehensive report.

Get My Free Ebook


Post a comment