Regional distribution of neuritic plaques in the nondemented elderly and subjects with very mild Alzheimer disease
Regional distribution of neuritic plaques in the nondemented elderly and subjects with very mild Alzheimer disease
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DOI：
10.1001/archneur.55.9.1185
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发表时间：
1998-09-01
影响因子：
--
通讯作者：
Mohs, RC
中科院分区：
文献类型：
--
作者：
Haroutunian, V;Perl, DP;Mohs, RC
背景资料：识别与阿尔茨海默病（AD）最早期症状最密切相关的神经病理学病变对于理解疾病过程和制定影响其进展的治疗策略至关重要。AD的典型神经病理学病变是先于、跟随认知功能减退的最早期体征，还是与认知功能减退的最早期体征同步发生？设计和结局指标：我们使用临床痴呆评定量表（CDR）评估了66名无痴呆、可疑痴呆或轻度痴呆的老年受试者的5个新皮质区和海马、内嗅皮质和杏仁核中神经炎斑块（NP）形成的程度。即使是可疑的痴呆（CDR，0.5）与新皮质NP密度的显着增加（P = 0.04）。在所有检查的脑区，随着痴呆严重程度的增加，NPs的密度进一步增加。然而，可疑痴呆或明确但轻度痴呆的受试者之间没有显著差异。在中度痴呆（CDR = 2.0）的受试者中，NPs的密度几乎最大，这表明其他神经病理学变化可能是导致认知缺陷超过这一水平的原因。痴呆严重程度与所有脑区NPs密度显著相关（r范围0.47-0.56; P
Background: Identification of the neuropathological lesions that are most closely associated with the earliest symptoms of Alzheimer disease (AD) is crucial to the understanding of the disease process and the development of treatment strategies to affect its progress. Do the classical neuropathological lesions of AD precede, follow, or occur in synchrony with the earliest signs of cognitive deterioration?Design and Outcome Measures: We examined the extent of neuritic plaque (NP) formation in 5 neocortical regions and the hippocampus, entorhinal cortex, and amygdala in 66 elderly subjects with no dementia, questionable dementia, or mild dementia as assessed using the Clinical Dementia Rating Scale (CDR).Setting and Patients: Postmortem study of nursing home residents.Results: Even questionable dementia (CDR, 0.5) was associated with a significant (P = .04) increase in neocortical NP density. The density of NPs increased further with increasing dementia severity in all brain regions examined. However, subjects with questionable dementia or definite but mild dementia did not differ significantly from each other. Density of NPs was nearly maximal in subjects with moderate dementia (CDR = 2.0), suggesting that other neuropathological changes may be responsible for cognitive deficits beyond this level. Dementia severity correlated significantly with the density of NPs in all brain regions examined (r range, 0.47-0.56; P