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Alzheimer's disease.  Section of neocortex stained with polyclonal antibody against βA4 peptide showing amyloid deposits in plaques in brain substance (arrow A) and in blood vessel walls (arrow B).

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  1. Alzheimer's disease. Section of neocortex stained with polyclonal antibody against βA4 peptide showing amyloid deposits in plaques in brain substance (arrow A) and in blood vessel walls (arrow B).

  2. Fronto-temporal dementia. Lateral view of formalin-fixed brain from a patient who died of Pick's disease, showing gyral atrophy of frontal and parietal lobes and a more severe degree of atrophy affecting the anterior half of the temporal lobe (arrow). High power (× 200) of hippocampal pyramidal layer, prepared with monoclonal anti-tau antibody. Many neuronal cell bodies contain sharply circumscribed, spherical cytoplasmic inclusion bodies (Pick bodies).

  3. Parkinson's disease. High power (× 400) of substantianigra of a patient with Parkinson's disease to show classical Lewy body (haematoxylin and eosin)

  4. Mechanisms of drug action in Parkinson's disease. (1) Decarboxylase inhibitors (carbidopa and benserazide) decrease side-effects by reducing peripheral conversion of levodopa to dopamine by aromatic amino acid decarboxylase (AAAD). (2) Active transport of levodopa into the brain may be inhibited by competition from dietary amino acids after a high-protein meal. (3) In the nigrostriatal neurons, levodopa is converted into dopamine. (4) Amantadine enhances the release of dopamine at the nerve terminal. (5) Dopamine agonists act directly on striatal receptors. (6) The monoamine oxidase type B (MAO-B) inhibitor selegiline increases the availability of neuronal dopamine by reducing its metabolism outside the neuron. (7) The catechol-O-methyl-transferase (COMT) inhibitor entacapone prolongs the availability of dopamine by inhibiting the metabolism of dopamine and levodopa outside the neuron.

  5. COMT Inhibitor acts both in blood and brain,while MAO-B in brain only.but both always act outside neuron.

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