PENDAHULUAN PEMBAHASAN KESIMPULAN 32 DAFTAR PUSTAKA 34

DAFTAR ISI Daftar Isi i Daftar Singkatan iii Daftar Gambar iv

I. PENDAHULUAN

I.1. Latar Belakang 1 I.2 Tujuan 2 I.3 Manfaat 2

II. PEMBAHASAN

II.1. Demensia Alzheimer 3

II.1.1. Definisi 3 II.1.2. Sejarah 3 II.1.3. Epidemiologi 4 II.1.4. Kriteria Diagnosis 5 II.1.4.1. Diagnosis Pasti Demensia Alzheimer 6 II.1.4.2. Probable Demensia Alzheimer 6 II.1.4.3. Possible Demensia Alzheimer 7 II.1.5.Gambaran Klinis 7 II.1.6. Patogenesis 8

II.2. Neurotransmitter

14 II.2.1. Neurotransmitter Asam Amino 14 II.2.1.1. Glutamat 14 II.2.1.2. Gamma-aminobutyric-acid GABA 15

II.2.2. Neurotransmitter Monoamin

16 II.2.2.1. Acetylcholine ACh 16 II.2.2.2. Dopamin 17 II.2.2.3. Norepinefrin dan Epinefrin 17 II.2.2.4. Serotonin 17 II.2.3. Neuropeptida 17 II.3. Abnormalitas Neurotransmitter Pada Demensia Alzheimer 19

II.3.1 Hipotesis Kolinergik pada Demensia Alzheimer

19 Universitas Sumatera Utara

II.3.2. Keterlibatan Neuron Glutamatergik pada Demensia Alzheimer

23 II.3.3. Keterlibatan Neuron GABAergik pada Demensia Alzheimer 28

II.3.4. Defisit Katekolamin Pada Korteks

29 II.3.5. Defisit Serotonin Pada Demensia Alzheimer 29

III. KESIMPULAN 32

II.3.6. Neuropeptida

30

IV. DAFTAR PUSTAKA 34

Universitas Sumatera Utara DAFTAR SINGKATAN AAE :asam amino eksitatorik ACh : acetylcholine AChE : acetylcholinesterase BACE : β site of APP cleavage enzyme CT scan : computed tomography scan CSF : Cerebrospinal fluid DA : Demensia Alzheimer EEG : electroencephaolography GABA : γ-aminobutyric acid GAD : glutamic acid decarboxylase ICD-10 : International Classifiation of Diseases, 10 th NFT : neurofibrillary tangles revision NINCDS-ADRDA : The National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer’s Disease and Related Disorders Association Work Group NMDA : N-methyl-D-aspartate PPA : protein perkursor amiloid SDAT : Senile Dementia Alzheimer Type SSRI : selective serotonin reuptake inhibitor Universitas Sumatera Utara DAFTAR GAMBAR Gambar 1. Kaskade Amiloid 9 Gambar 2. Proses PPA normal dan patologis 10 Gambar 3. Pembentukan β-Amiloid 12 Gambar 4. Agregasi β-Amiloid 13 Gambar 5. Mekanisme neurokimiawi sinyal glutamatergik 15 Gambar 6. Mekanisme neurokimiawi sinyal kolinergik 17 Gambar 7. Hipotesis Kolinergik 21 Gambar 8. Hipotesis Glutamat 24 Universitas Sumatera Utara

I. PENDAHULUAN