Correlation of Alzheimer disease neuropathologic changes with cognitive status: a review of the literature.
Correlation of Alzheimer disease neuropathologic changes with cognitive status: a review of the literature.
复制标题
DOI：
10.1097/nen.0b013e31825018f7
复制
发表时间：
2012-05
影响因子：
3.2
通讯作者：
Beach TG
中科院分区：
文献类型：
--
作者：
Nelson PT;Alafuzoff I;Bigio EH;Bouras C;Braak H;Cairns NJ;Castellani RJ;Crain BJ;Davies P;Del Tredici K;Duyckaerts C;Frosch MP;Haroutunian V;Hof PR;Hulette CM;Hyman BT;Iwatsubo T;Jellinger KA;Jicha GA;Kövari E;Kukull WA;Leverenz JB;Love S;Mackenzie IR;Mann DM;Masliah E;McKee AC;Montine TJ;Morris JC;Schneider JA;Sonnen JA;Thal DR;Trojanowski JQ;Troncoso JC;Wisniewski T;Woltjer RL;Beach TG
临床病理相关性研究对于阿尔茨海默病（AD）研究领域至关重要。对人类受试者的尸检确认的研究涉及许多潜在的偏见，影响他们的普遍适用性和相关性的有效性。许多来源的数据变异性可以削弱认知状态和AD神经病理变化之间的明显相关性。事实上，大多数人在先进的老年有显着的非AD脑病变，可能会改变认知独立于AD。世界范围内的研究工作已经评估了数千名人类受试者，以评估老年人认知障碍的原因，这些研究已经以不同的方式进行了解释。我们回顾了AD神经病理学改变（即β-淀粉样斑块和神经元缠结）与认知功能障碍的相关性。我们讨论了在老年人中观察到的各种脑变化模式，为理解AD临床病理学相关性提供了一个视角，并得出结论，许多独立研究中心的证据强烈支持特定疾病的存在，如Aβ斑块和神经元缠结的存在。虽然Aβ斑块可能在AD发病机制中起关键作用，但认知功能障碍的严重程度与新皮质神经元缠结的负担最相关。
Clinicopathologic correlation studies are critically important for the field of Alzheimer disease (AD) research. Studies on human subjects with autopsy confirmation entail numerous potential biases that affect both their general applicability and the validity of the correlations. Many sources of data variability can weaken the apparent correlation between cognitive status and AD neuropathologic changes. Indeed, most persons in advanced old age have significant non-AD brain lesions that may alter cognition independently of AD. Worldwide research efforts have evaluated thousands of human subjects to assess the causes of cognitive impairment in the elderly, and these studies have been interpreted in different ways. We review the literature focusing on the correlation of AD neuropathologic changes (i.e. β-amyloid plaques and neurofibrillary tangles) with cognitive impairment. We discuss the various patterns of brain changes that have been observed in elderly individuals to provide a perspective for understanding AD clinicopathologic correlation and conclude that evidence from many independent research centers strongly supports the existence of a specific disease, as defined by the presence of Aβ plaques and neurofibrillary tangles. Although Aβ plaques may play a key role in AD pathogenesis, the severity of cognitive impairment correlates best with the burden of neocortical neurofibrillary tangles.