home

**Welcome to My Wiki Project** **History and Systems PSY4604** **Laura Emory** **University of Central Florida** **Spring 2012**

=Psychopathology of Alzheimer's Disease =



More than one hundred years ago, neurologist, Dr. Alois Alzheimer described an unusual case of presenile dementia at a conference of psychiatrists in Tubingen, Germany on November 4, 1906. During the lecture Dr. Alzheimer explained the case of a 51 year old female named Auguste Deter who was admitted, in 1901, to the Municipal Hospital for Lunatics and Epileptics (Städtische Irrenanstalt) in Frankfurt am Main, headed by Emil Sioli. The case files of Alzheimer's famous patient have since been found and translated.

Research by Maurer and Volk (1997) uncovered the records of Auguste D's case which had not been seen for over ninety years. The records were amazingly intact and revealed the extensive writings by Alzheimer regarding Auguste D. and were then translated from the Latin and outdated Sutterlin script. As cited by Maurer and Volk,1997, Alzheimer's lecture publication in 1907, titled,"A characteristic serious disease of the cerebral cortex". He presents "the case of a patient who was kept under close observation during institutionalisation at the Frankfurt Hospital and whose central nervous system had been given to me by director Sioli for further examination". Without mention of her name, Alzheimer described, a "51-year-old woman" who showed "as one of her first disease symptoms a strong feeling of jealously towards her husband.Very soon she showed rapidly increasing memory impairments; she was disoriented carrying objects to and fro in her flat and hid them. Sometimes she felt that someone wanted to kill her and began to scream loudly... After 41/2 years of sickness she died".



During the five years of her hospitalization, she would progress to violent behavior and hallucinations eventually becoming unresponsive, and curled up in a fetal position. Auguste Deter passed away in April 1906, at the age of 55. At that time Alzheimer was studying in Munich, his focus of research among others was forensic psychiatry, epilepsy and a strong interest in the neuropathology of dementing disorders. His colleague Franz Nissl had recently developed a method for staining tissue of the nervous system. This histopatholigcal technique would improve Alzheimer's research of nervous disorders, and allow him to uncover the amyloid plaques and neurofibrillary tangles that describe Alzheimer's disease today (Cipriani, Dolciotti, Picchi, Bonucelli, 2011).

Alzheimer described patient Auguste D. as having, "eine eigenartige Erkrankung der Hirnrinde" (a peculiar disease of the cerebral cortex). In his observations he noted the characteristic amyloid plaques and neurofribillary tangles that are the hallmark for post mortem diagnosis of Alzheimer's Disease today. As cited by Maurer and Volk (1997), Alzheimer wrote "In the centre of an otherwise almost normal cell there stands out one or several fibrils due to their characteristic thickness and peculiar impregnability". He went on to describe the typical plaques, later named after him: "Numerous small miliary foci are found in the superior layers. They are determined by the storage of a peculiar material in the cortex". Alzheimer continues: "all in all we have to face a peculiar disease process. Such peculiar disease processes have been verified recently in considerable numbers". In 1910 Alzheimer's boss, Emil Kraepelin, published the eighth edition of his book //Psychiatrie// in which he describes Alzheimer's findings and subsequently names Auguste D.'s condition 'Alzheimer's Disease'.



Source: Maurer and Volk, (1997) Contained in the case records they found

The case of Auguste D. was unusual in that she presented behavior characteristic of dementia which was believed at the time to be a condition characteristic of much older persons. Auguste D. presented with impaired memory, disorientation, aphasia and psychosocial incompetence (the definition of dementia at that time) (Mo, 2007). Alzheimer's diagnosis was presenile dementia. Today's diagnosis would be early onset Alzheimer's Disease.