Absence of neurodegeneration and neural injury in the cerebral cortex in a sample of elderly patients with schizophrenia
Absence of neurodegeneration and neural injury in the cerebral cortex in a sample of elderly patients with schizophrenia
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DOI：
10.1001/archpsyc.55.3.225
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发表时间：
1998-03-01
影响因子：
--
通讯作者：
Choi, C
中科院分区：
文献类型：
--
作者：
Arnold, SE;Trojanowski, JQ;Choi, C
背景：在许多“预后不良”的精神分裂症患者中观察到的认知和功能恶化表明神经退行性过程延伸到晚年。先前的诊断研究排除了已知的神经退行性疾病作为这种痴呆症的解释。然而，我们假设，年龄或疾病相关的神经退行性病变在异常大脑中相对较小的积累可能导致精神分裂症的恶化。方法：对23例死亡前已确定临床评分的慢性精神分裂症老年患者、14例无神经精神疾病的老年对照患者和10例阿尔茨海默病对照患者进行死后研究。免疫组织化学和无偏体视计数方法被用于量化常见的神经退行性病变（即神经原纤维结、淀粉样斑块和路易小体）和细胞对各种有害刺激（泛素化营养不良神经突起、星形细胞增生和小胶质浸润）在腹内侧颞叶、额叶和胼胝体（初级视觉）皮层的反应。结果：在精神分裂症患者和没有神经精神疾病的对照组患者之间，任何标记物的密度都没有统计学上的显著差异，而两组患者的病变都少于阿尔茨海默病对照组。精神分裂症样本的相关分析未能确定认知和精神病学评分以及任何神经病理学标记物密度之间的显著相关性。结论：在老年精神分裂症患者的样本中，没有发现明显的神经退行性变或持续的大脑皮层神经损伤的证据。此外，晚年观察到的行为和认知退化与年龄相关的退化现象无关。
Background: The cognitive and functional deterioration that is observed in many "poor-outcome" patients with schizophrenia suggests a neurodegenerative process extending into late life. Previous diagnostic studies have excluded known neurodegenerative diseases as explanations for this dementia. However, we hypothesized that relatively small accumulations of age-or disease-related neurodegenerative lesions occurring in an otherwise abnormal brain could result in deterioration in schizophrenia.Methods: Postmortem studies were conducted using 23 prospectively accrued elderly persons with chronic schizophrenia for whom clinical ratings had been determined before death, 14 elderly control patients with no neuropsychiatric disease, and 10 control patients with Alzheimer disease. Immunohistochemistry and unbiased stereological counting methods were used to quantify common neurodegenerative lesions (ie, neurofibrillary tangles, amyloid plaques, and Lewy bodies) and cellular reactions to a variety of noxious stimuli (ubiquitinated dystrophic neurites, astrocytosis, and microglial infiltrates) in the ventromedial temporal lobe and the frontal and the calcarine (primary visual) cortices.Results: No statistically significant differences were found between the patients with schizophrenia and the control patients without neuropsychiatric disease for the densities of any of the markers, while both groups exhibited fewer lesions than did the control group with Alzheimer disease. Correlation analyses in the schizophrenia sample failed to identify significant correlations between cognitive and psychiatric ratings and densities of any of the neuropathologic markers.Conclusions: No significant evidence of neurodegeneration or ongoing neural injury in the cerebral cortex was found in this sample of elderly persons with schizophrenia. Furthermore, the behavioral and cognitive deterioration observed in late life did not correlate with age-related degenerative phenomena.