Neuropathological substrates of psychiatric symptoms in prospectively studied patients with autopsy-confirmed dementia with Lewy bodies
Neuropathological substrates of psychiatric symptoms in prospectively studied patients with autopsy-confirmed dementia with Lewy bodies
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DOI：
10.1176/appi.ajp.161.5.843
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发表时间：
2004-05-01
影响因子：
17.7
通讯作者：
McKeith, IG
中科院分区：
文献类型：
--
作者：
Ballard, CG;Jacoby, R;McKeith, IG
目的：这项调查进行了澄清的神经病理学基板的关键精神症状的痴呆Lewy body.Method：作者研究了112例尸检证实的痴呆症与Lewy bodies的患者谁有每年的标准化临床评估，直到他们的死亡。评估了持续性精神症状（幻视、妄想、抑郁）与斑块（建立阿尔茨海默病登记协议联盟）、缠结（Braak分期）和路易体（共识路易体分期）的关系。此外，症状的频率和持续的症状进行了比较，在路易体痴呆和90例尸检证实阿尔茨海默氏病的前瞻性研究在life.Results：主要的神经病理相关的持续性幻视的患者是存在较轻的缠结病理，但有缠结病理和持续性妄想之间没有显着的关联。路易体分期与持续性幻视和持续性妄想的存在有关。与阿尔茨海默病相比，路易体痴呆患者的所有基线精神病学特征明显更常见，持续性幻视也是如此，但路易体痴呆和严重缠结病理的患者的临床症状与阿尔茨海默病患者更相似，并且不太可能有新皮质路易体。结论：路易体痴呆和更严重的缠结病理学的患者比例适中，临床上类似于阿尔茨海默病患者。与阿尔茨海默病不同，路易体痴呆症显示出缠结负担和精神病之间的显着负相关。
Objective: This investigation was undertaken to clarity the neuropathological substrates of key psychiatric symptoms in dementia with Lewy bodies.Method: The authors studied 112 autopsy-confirmed cases of dementia with Lewy bodies in patients who had had annual standardized clinical evaluations until their death. The relationships of persistent psychiatric symptoms (visual hallucinations, delusions, depression) to plaques (Consortium to Establish a Registry for Alzheimer's Disease protocol), tangles (Braak staging), and Lewy bodies (consensus Lewy body staging) were evaluated. in addition, symptom frequency and persistent symptoms were compared in the patients with Lewy body dementia and 90 patients with autopsy-confirmed Alzheimer's disease studied prospectively during life.Results: The main neuropathological correlate of persistent visual hallucinations was the presence of less severe tangle pathology, but there was no significant association between tangle pathology and persistent delusions. Lewy body staging was associated with the presence of persistent visual hallucinations and persistent delusions. All baseline psychiatric features were significantly more frequent in dementia with Lewy bodies than in Alzheimer's disease, as were persistent visual hallucinations, but patients who had dementia with Lewy bodies and severe tangle pathology had a clinical symptom profile more similar to that of Alzheimer's disease patients and were less likely to have neocortical Lewy bodies.Conclusions: The modest proportion of patients with Lewy body dementia and more severe tangle pathology resembled Alzheimer's disease patients clinically. Unlike Alzheimer's disease, dementia with Lewy bodies showed a significant inverse association between tangle burden and psychosis.