You might want to check to see if you've added any newer hardware or hardware drivers (other than video).
For instance -- I know there are some printer driver-apps (the little bastards that sit in the system tray) that will constantly poll the status of the printer. Depending on how the system's set up, etc. etc. it'll cause random micro-pauses in the computer operation and drive you absolutely batty until you figure it out.
Just a suggestion -- Perhaps it's something other than video drivers. Hardware or software additions to the system, etc.
Also, Extremetech links 4 great Vista hotfixes not yet part of Windows Update (I think)
http://www.extremetech.com/art.../0,1697,2177716,00.asp
one of these is the memory leak problem in Vista. See if that helps.
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As for moving up to 4GB, it's nice, but it may not be a cure-all.
Even if you move to 4GB and Vista-64, you're still running into a 2GB user-mode space limitation from the app itself because it's not a 64-bit compiled app. Only if the app is "LargeAddressAware" is 64-bit going to help, but in that case a /3GB switch may help a normal Vista-32 installation.
http://blogs.msdn.com/oldnewth...2005/06/01/423817.aspx
http://msdn2.microsoft.com/en-us/library/ms791558.aspx
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I'm currently running my 8800GTS, Vista-32, and have yet to experience any sort of performance you're describing. I'm using current BETA drivers from Nvidia. So, I'm thinking it has to do with either a faulty/corrupt Vista installation or some other interfering software/hardware that's been added.