Alpha-synuclein cortical Lewy bodies correlate with dementia in Parkinson's disease
Alpha-synuclein cortical Lewy bodies correlate with dementia in Parkinson's disease
复制标题
DOI：
10.1212/wnl.54.10.1916
复制
发表时间：
2000-05-23
期刊：
影响因子：
9.9
通讯作者：
Arnold, SE
中科院分区：
文献类型：
--
作者：
Hurtig, HI;Trojanowski, JQ;Arnold, SE
背景：痴呆是特发性帕金森综合征（PD）的常见并发症，通常发生在病程较长的晚期。PD的神经病理改变主要发生在黑质，但PD痴呆的神经病理和分子基础尚不清楚。虽然阿尔茨海默氏症的病理一直是一个常见的发现，最近的进展，在α-突触核蛋白的免疫染色表明，可能的重要性，皮质路易体（CLB）在痴呆患者的大脑PD。研究方法：采用标准的神经病理学技术对22例痴呆和20例非痴呆患者的临床和神经病理学诊断为PD的大脑进行了评估。此外，CLB和营养不良的神经突用α-突触核蛋白和泛素特异性抗体进行化学鉴定;斑块和缠结用硫磺素S染色进行鉴定。痴呆状态和病理标志物之间的关联用逻辑回归进行检验。结果如下：α-突触核蛋白阳性的CLB是PD痴呆的高度敏感（91%）和特异性（90%）的神经病理学标志物，比泛素阳性的CLB稍敏感。与神经纤维缠结、淀粉样斑块或营养不良的神经突相比，它们是更好的痴呆指标。结论：在PD患者中通过α-突触核蛋白抗体检测到的CLB是比阿尔茨海默病病理学的存在更敏感和特异的痴呆相关性，阿尔茨海默病病理学存在于该系列中的少数病例中。
Background: Dementia is a frequent complication of idiopathic parkinsonism or PD, usually occurring later in the protracted course of the illness. The primary site of neuropathologic change in PD is the substantia nigra, but the neuropathologic and molecular basis of dementia in PD is less clear. Although Alzheimer's pathology has been a frequent finding, recent advances in immunostaining of alpha-synuclein have suggested the possible importance of cortical Lewy bodies (CLBs) in the brains of demented patients with PD. Methods: The brains of 22 demented and 20 nondemented patients with a clinical and neuropathologic diagnosis of PD were evaluated with standard neuropathologic techniques. In addition, CLBs and dystrophic neurites were identified immunohistochemically with antibodies specific for alpha-synuclein and ubiquitin; plaques and tangles were identified by staining with thioflavine S. Associations between dementia status and pathologic markers were tested with logistic regression. Results: CLBs positive for alpha-synuclein are highly sensitive (91%) and specific (90%) neuropathologic markers of dementia in PD and slightly more sensitive than ubiquitin-positive CLBs. They are better indicators of dementia than neurofibrillary tangles, amyloid plaques, or dystrophic neurites. Conclusion: CLBs detected by alpha-synuclein antibodies in patients with PD are a more sensitive and specific correlate of dementia than the presence of Alzheimer's pathology, which was present in a minority of the cases in this series.