Analysis of the adrenal gland is useful for evaluating pathology of the peripheral autonomic nervous system in Lewy body disease
Analysis of the adrenal gland is useful for evaluating pathology of the peripheral autonomic nervous system in Lewy body disease
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DOI：
10.1097/nen.0b013e3180517454
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发表时间：
2007-05-01
影响因子：
3.2
通讯作者：
Murayama, Shigeo
中科院分区：
文献类型：
--
作者：
Fumimura, Yuichi;Ikemura, Masako;Murayama, Shigeo
路易体病被定义为涉及黑质纹状体系统、边缘新皮质系统和周围自主神经系统（PANS）的路易体相关神经元变性。我们研究了肾上腺（在进化上与交感神经节相关并在一般尸检中常规检查）是否可用于评估路易体病中 PANS 的病理学。使用抗磷酸化 α-突触核蛋白抗体和常规染色对来自一家综合老年医院的 783 例连续尸检病例的脑、脊髓和肾上腺进行免疫组织化学检查。帕金森病 (PD) 伴痴呆和路易体痴呆 (DLB) 使用 1996 年 DLB 共识指南进行定义，继发性路易体相关 α-突触核蛋白病或杏仁核变异使用先前制定的标准进行定义。 783 例中的 207 例（26.4%）发现路易体相关的 α-突触核蛋白病，其中 I 例仅发生在肾上腺。在所有 18 例伴或不伴痴呆的 PD 病例中，以及 38 例 DLB 病例中的 33 例中，肾上腺受累，但在所有杏仁核变异病例中，肾上腺均未受累。我们的结果表明，肾上腺可以为评估路易体病中的 PANS 提供有用的信息。
Lewy body disease is defined as Lewy body-related neuronal degeneration involving the nigrostriatal system, limbic-neocortical system, and peripheral autonomic nervous system (PANS). We investigated whether the adrenal gland, which is evolutionarily related to sympathetic ganglia and is routinely examined in general autopsy, could be used to assess pathology of the PANS in Lewy body disease. Brains, spinal cords, and adrenal glands from 783 consecutive autopsy cases from a general geriatric hospital were examined immunohistochemically with antiphosphorylated alpha-synuclein antibodies and routine staining. Parkinson disease (PD) with dementia and dementia with Lewy bodies (DLB) were defined using 1996 Consensus Guidelines for DLB and the secondary Lewy body-related alpha-synucleinopathy or amygdala variants using previously established criteria. Lewy body-related alpha-synucleinopathy was found in 207 (26.4%) of 783 cases, with I case solely in the adrenal gland. In all 18 PD cases with or without dementia and in 33 of 38 DLB cases, the adrenal gland was involved, but it was spared in all cases of amygdala variants. Our results indicate that the adrenal gland can provide useful information for evaluation of the PANS in Lewy body disease.