Does striatal pathology distinguish Parkinson disease with dementia and dementia with Lewy bodies?
Does striatal pathology distinguish Parkinson disease with dementia and dementia with Lewy bodies?
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DOI：
10.1007/s00401-006-0088-2
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发表时间：
2006-09-01
影响因子：
12.7
通讯作者：
Attems, Johannes
中科院分区：
文献类型：
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作者：
Jellinger, Kurt A.;Attems, Johannes
帕金森病合并痴呆(PDD)和路易体痴呆(DLB)的形态区别是一个值得讨论的问题。这项研究的目的是调查两种疾病中β-淀粉样蛋白(Aβ)斑块、α-突触核蛋白(AS)的区域分布和病理学。使用Aβ、AS和tau抗体对17例年龄匹配的PDD和DLB患者的基底节进行免疫组织化学检查，发现与不同程度的阿尔茨海默病相关的病理改变。尽管神经元性Braak分期相似，但DLB脑显示壳核和尾状核中(弥漫性)淀粉样斑块的负荷显著高于PDD脑，并且tau病理略重于PDD脑。DLB脑中Aβ发育的阶段通常与神经元性Braak分期和纹状体Aβ负荷的严重程度相关，但不一致，而这些相关性在患有阿尔茨海默病的PDD病例中几乎从未见过。他们还发现AS病变(路易轴突和路易小体)的负担比PDD病例更高，后者通常缺乏所有三种类型的病变。苍白球在这两种表型上几乎都是幸免于难。纹状体AS和Aβ病理的不同以及tau损伤的较少支持PDD和DLB之间的形态差异，这可能具有重要的病理生理意义，但这些差异的原因尚不清楚。
The morphological differentiation of Parkinson disease with dementia (PDD) and dementia with Lewy bodies (DLB) is a matter of discussion. The objective of this study was to investigate the regional distribution of beta-amyloid (A beta) plaques, alpha-synuclein (AS), and pathology in both disorders. The basal ganglia from 17 age-matched patients of PDD and DLB each were immunohistochemically examined with variable degrees of associated Alzheimer pathology using antibodies to A beta, AS, and tau. DLB brains showed a significantly higher burden of (diffuse) amyloid plaques in the putamen and caudate nucleus and slightly more severe tau pathology than PDD brains despite similar neuritic Braak stages. Phases of A beta development in DLB brains often, but inconsistently, correlated with both neuritic Braak stages and severity of striatal A beta load, while these correlations were almost never seen in PDD cases with Alzheimer lesions. They also revealed a higher burden of AS-lesions (both Lewy neurites and Lewy bodies) than PDD cases that commonly had a paucity of all three types of lesion. The globus pallidus was virtually spared in both phenotypes. Differences in AS and A beta pathologies and much less of tau lesions in the striatum support a morphologic distinction between PDD and DLB, which may be of pathophysiologic importance, but the causes of these differences are unclear.