Macroscopic diagnostic clue for parkinsonism
Macroscopic diagnostic clue for parkinsonism
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帕金森病的宏观诊断线索
DOI：
10.1111/neup.12853
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发表时间：
2022
期刊：
影响因子：
2.3
通讯作者：
Iwasaki Yasushi
中科院分区：
文献类型：
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作者：
Yoshida Mari;Akagi Akio;Miyahara Hiroaki;Riku Yuichi;Ando Takashi;Ikeda Toshimasa;Yabata Hiroyuki;Moriyoshi Hideyuki;Koizumi Ryuichi;Iwasaki Yasushi
帕金森病的神经病理学背景包括各种神经退行性疾病，包括路易体病（LBD）、多系统萎缩（MSA）、进行性核上性麻痹（PSP）和皮质基底节变性（CBD）。病理诊断程序首先评估宏观发现，用肉眼评估大脑中的退行性病变。通常，退行性病变根据疾病特异性表现出不同程度的萎缩和褐色变色。这些宏观外观支持神经病理学家识别相关区域进行显微镜检查。帕金森病的神经病理学诊断基于神经元和神经胶质细胞的区域分布和基本蛋白质病变。 LBD 和 MSA 是突触核蛋白病，PSP 和 CBD 是 tau蛋白病。其中，胶质为主的蛋白病（MSA、PSP 和 CBD）可能在体积减少中发挥重要作用。因此，宏观检查为评估提供了适当的方向。疾病持续时间、病变严重程度和混合病理使宏观观察的验证变得更加复杂。在这篇综述中，我们概述了 LBD、MSA、PSP 和 CBD 中有助于病理细化的宏观诊断线索。
The neuropathological background of parkinsonism includes various neurodegenerative disorders, including Lewy body disease (LBD), multiple system atrophy (MSA), progressive supranuclear palsy (PSP), and corticobasal degeneration (CBD). The pathological diagnostic procedure begins by assessing the macroscopic findings to evaluate the degenerative lesions in brains with the naked eye. Usually, degenerative lesions show variable atrophy and brownish discoloration in accordance with disease‐specific profiles. These macroscopic appearances support neuropathologists in identifying the relevant regions for microscopic examination. The neuropathological diagnosis of parkinsonism is based on regional distribution and fundamental proteinopathies in neurons and glia cells. LBD and MSA are synucleinopathies, and PSP and CBD are tauopathies. Among them, glial‐predominant proteinopathy (MSA, PSP, and CBD) may play a significant role in volume reduction. Therefore, macroscopic inspection provides the appropriate direction for assessment. The disease duration, the severity of lesions, and mixed pathologies make the validation of macroscopic observations more complicated. In this review, we outline the macroscopic diagnostic clues in LBD, MSA, PSP, and CBD that could help with pathological refinement.