HISTOPATHOLOGIC CORRELATES OF WHITE-MATTER CHANGES ON MRI IN ALZHEIMERS-DISEASE AND NORMAL AGING
HISTOPATHOLOGIC CORRELATES OF WHITE-MATTER CHANGES ON MRI IN ALZHEIMERS-DISEASE AND NORMAL AGING
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DOI：
10.1212/wnl.45.5.883
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发表时间：
1995-05-01
期刊：
影响因子：
9.9
通讯作者：
KAMPHORST, W
中科院分区：
文献类型：
--
作者：
SCHELTENS, P;BARKHOF, F;KAMPHORST, W
我们使用尸检MRI研究了阿尔茨海默病(AD)患者(n=6)和对照组(n=9)脑白质变化的组织病理学相关性。51个地区的脑白质变化被评为0到3分。在组织病理学上，我们主观地评估了脑室深部和脑室周围白质中有髓轴突的丢失、室管室管膜剥脱、胶质增生、血管周围间隙的宽度和软脑膜固有性血管病；我们以微米为单位测量了白质中血管壁的结构变化。阿尔茨海默病患者脑白质高信号的MRI表现明显多于对照组。病理组织学上，AD组脑室管膜剥脱和胶质细胞增生明显重于对照组，且有更多的有髓轴突在AD脑深层白质丢失(p=0.07)。MRI异常与深部白质有髓轴突丢失(r‘=0.37；p<；0.01)和脑室衬里剥脱(r’=0.54；p<；0.01)相关。我们没有发现任何动脉硬化的证据，但AD组深白质动脉外膜的平均厚度几乎是对照组的两倍(p=0.0009)。我们得出结论，AD患者和对照组的白质异常包括有髓轴突的丢失，这可能是由动脉变化和脑室衬里破裂引起的。由于AD患者和对照组的影像/组织病理学相关性相似，这些变化可能代表了某种形式的加速衰老。
We investigated the histopathologic correlates of white matter changes in Alzheimer's disease (AD) patients (n = 6) and controls (n = 9) using postmortem MRI. White matter changes were rated on a 0 to 3 scale in 51 regions. Histopathologically, we subjectively rated the loss of myelinated axons in the deep and periventricular white matter, denudation of the ventricular ependyma, gliosis, width of the perivascular spaces, and leptomeningeal congophilic angiopathy; we measured structural changes in the walls of the blood vessels in the white matter in micrometers. The AD brains displayed significantly more white matter hyperintensities on MRI than controls. Histopathologically, the denudation of the ventricular ependyma and the gliosis were significantly more severe in AD than in controls, and there was a trend toward more loss of myelinated axons in the deep white matter in the AD brains (p = 0.07). The MRI abnormalities correlated with the loss of myelinated axons in the deep white matter (r' = 0.37; p < 0.01) and with the denudation of the ventricular lining (r' = 0.54; p < 0.01). We could not find any evidence for arteriolosclerosis, but the mean thickness of the adventitia of the arteries of the deep white matter in AD almost doubled the value in control brains (p = 0.0009). We conclude that white matter abnormalities in AD patients and controls consist of loss of myelinated axons, probably caused by arterial changes and breakdown of the ventricular lining. Since imaging/histopathologic correlation was similar in AD patients and controls, these changes probably represent some form of accelerated aging.