Staging of Alzheimer-related cortical destruction.
Staging of Alzheimer-related cortical destruction.
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DOI：
10.1017/s1041610297004973
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发表时间：
1997-01-01
影响因子：
7
通讯作者：
Braak, E
中科院分区：
文献类型：
--
作者：
Braak, H;Braak, E
目前使用的阿尔茨海默病 (AD) 神经病理学诊断标准仅允许区分完全发展的 AD 或病理改变不太严重的不明确病例。需要一种能够补充当前使用的标准的分期程序，以允许在疾病的初始阶段和中期阶段之间进行充分区分，并提供“非痴呆、与年龄相关的对照”的脑组织受累程度的表征。 AD 潜在的破坏性过程的特点是大脑变化的典型分布模式，该模式特定于区域、椎板甚至细胞类型。最显着的变化是异常蛋白质在神经细胞之间和内部的逐渐沉积。识别这些沉积物的传统染色方法缺乏敏感性和特异性。银方法（特别是用于神经原纤维变化的 Gallyas 碘化银技术和用于大脑淀粉样蛋白的 Campbell-Switzer 银吡啶技术）是迄今为止最适合诊断工作的方法。它们价格便宜、使用简单并且更加可靠。本文描述了每种技术在逐渐严重的 AD 患者大脑中通常发现的染色模式，并描述了如何将观察到的特定变化用作诊断目的的分期系统。
Currently used criteria for neuropathological diagnosis of Alzheimer's disease (AD) allow only the distinction of fully developed AD or ill-defined cases with less severe pathologic alterations. There is a need for a staging procedure that is able to supplement the currently used criteria, to allow for sufficient differentiation between the initial and intermediate stages of the illness, and to provide a characterization of the degree of involvement in the brain tissue of "nondemented, age-related controls." The destructive process underlying AD is characterized by a typical distribution pattern of brain changes that is specific with respect to area, lamina, and even cell type. The most conspicuous change is the progressive deposition of abnormal proteins, both between and within the nerve cells. Conventional staining methods to identify these deposits lack sensitivity and specificity. Silver methods (specifically the Gallyas silver-iodide technique for neurofibrillary changes and the Campbell-Switzer silver-pyridin technique for brain amyloid) are by far the best suited to diagnostic work. They are inexpensive, simple to use, and far more reliable. This article describes the patterns of staining typically found with each of these techniques in the brains of patients with progressively severe AD and describes how the specific changes observed can be used as a staging system for diagnostic purposes.