Mixed Brain Pathologies in Dementia: The BrainNet Europe Consortium Experience
Mixed Brain Pathologies in Dementia: The BrainNet Europe Consortium Experience
复制标题
DOI：
10.1159/000161560
复制
发表时间：
2008-01-01
影响因子：
2.4
通讯作者：
Budka, Herbert
中科院分区：
文献类型：
--
作者：
Kovacs, Gabor G.;Alafuzoff, Irina;Budka, Herbert
背景：痴呆症是由大脑的异质性疾病引起的。混合疾病形式越来越被认识到。方法：我们在BrainNet欧洲的脑库中进行了一项调查，以估计潜在痴呆的混合疾病形式的比例以及年龄和性别特定的影响。结果：分析了从9个中心收集的3,303人的数据。在所有阿尔茨海默病（AD）、血管性病理（VP）、嗜银颗粒性痴呆（AGD）和突触核蛋白病（如路易体痴呆（LBD）、帕金森病（PD）和仅发生在杏仁核的突触核蛋白病理）的病例中，混合诊断的患者比例为53.3%。混合病理在LBD、PD、AGD和VP中比在AD中更常见。中心间AGD和VP混合诊断的百分比有显著差异。在年龄小于75岁的患者中，突触核蛋白病以及单纯形式的AD、VP和AGD在男性中更为常见。75岁以上女性有更多的单纯AD和单纯AGD。结论：最明显的神经病理改变不应终止诊断程序，因为病理很可能被发现。AGD和VP的神经病理学解释尚未充分建立共识。单纯形式的突触核蛋白病不太可能是痴呆的唯一底物。版权所有2008 S. Karger AG，巴塞尔
Background: Dementia results from heterogeneous diseases of the brain. Mixed disease forms are increasingly recognized. Methods: We performed a survey within brain banks of BrainNet Europe to estimate the proportion of mixed disease forms underlying dementia and age- and gender-specific influences. Results: Data collected in 9 centres from 3,303 individuals were analysed. The proportion of patients with mixed diagnoses among all cases with Alzheimer disease (AD), vascular pathology (VP), argyrophilic grain dementia (AGD), and synucleinopathies, such as Lewy body dementia (LBD), Parkinson disease (PD) and synuclein pathology only in the amygdala, was 53.3%. Mixed pathology was more frequently reported with LBD, PD, AGD, and VP than with AD. The percentage of mixed diagnoses for AGD and VP significantly differed between centres. In patients younger than 75 years, synucleinopathies, and pure forms of AD, VP, and AGD were more frequent in men. Above 75 years of age, more women had pure AD and pure AGD. Conclusions: The most obvious neuropathological alteration should not terminate the diagnostic procedure since copathology is likely to be found. Neuropathological interpretation of AGD and VP has not been sufficiently established in a consensus. Pure forms of synucleinopathies are unlikely sole substrates for dementia. Copyright (C) 2008 S. Karger AG, Basel