Distribution of cerebral amyloid deposition and its relevance to clinical phenotype in Lewy body dementia
Distribution of cerebral amyloid deposition and its relevance to clinical phenotype in Lewy body dementia
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DOI：
10.1016/j.neulet.2010.09.036
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发表时间：
2010-12-03
影响因子：
2.5
通讯作者：
Sato, Kiyoshi
中科院分区：
文献类型：
--
作者：
Fujishiro, Hiroshige;Iseki, Eizo;Sato, Kiyoshi
帕金森病痴呆（POD）和路易体痴呆（DLB）在临床上仅根据痴呆前的帕金森病程来区分。众所周知，这两种情况在病理上有相当大的重叠，但它们之间的病理差异尚不清楚。我们使用基于Brain-Net Europe （BNE）联盟的标准化方法评估了30例路易体痴呆患者的阿尔茨海默病型病理。13例POD病例中仅有2例（15%）表现为中脑β -免疫反应性病理（淀粉样蛋白IV期）。相反，17例DLB病例中有12例（71%）表现中脑受累。4例DLB病例（24%）表现为小脑β -免疫反应性病理（淀粉样蛋白V期），而POD病例中没有一例。脑膜下淀粉样蛋白沉积累及DLB的比例明显高于PDD。DLB的淀粉样蛋白期中位数明显高于PDD，但神经原纤维缠结（NFT） Braak分期和路易体评分没有差异。当患者按照先发生痴呆还是先发生帕金森病进行分类时，淀粉样蛋白期IV和V的痴呆发生率明显高于0-1期，III期居中，但与淀粉样蛋白期相关的NET Braak分期中位数和Lewy body评分中位数无显著差异。这些结果表明，淀粉样蛋白沉积可能与路易体痴呆的帕金森病发病时间有关。2010爱思唯尔爱尔兰有限公司版权所有。
Parkinson's disease dementia (POD) and dementia with Lewy bodies (DLB) are clinically distinguished based only on the duration of parkinsonism prior to dementia. It is known that there is considerable pathological overlap between these two conditions, but the pathological difference between them remains unknown. We evaluated Alzheimer-type pathology in 30 brains of patients with Lewy body dementia using standardized methods based on those of the Brain-Net Europe (BNE) Consortium. Only 2 of 13 POD cases (15%) showed A beta-immunoreactive pathology in the midbrain (amyloid phase IV). In contrast, 12 of 17 DLB cases (71%) exhibited midbrain involvement. Four of the DLB cases (24%) but none of the POD cases exhibited A beta-immunoreactive pathology in the cerebellum (amyloid phase V). The ratio of cases with subtentorial involvement of amyloid deposition was significantly higher in DLB than in PDD. The median of amyloid phases was significantly greater in DLB than in PDD, but there was no difference in neurofibrillary tangle (NFT) Braak stages or in Lewy body scores. When patients were classified according to whether dementia or parkinsonism had occurred first, the rate of dementia having occurred first was significantly greater in amyloid phase IV and V than in phase 0-1, with phase III in the middle, though there was no significant difference in median NET Braak stage or mean Lewy body score associated with amyloid phase. These results suggest that amyloid deposition may contribute to the timing of the onset of dementia relative to that of parkinsonism in Lewy body dementia. (C) 2010 Elsevier Ireland Ltd. All rights reserved.