Dementia with Lewy bodies and Alzheimer's disease
Dementia with Lewy bodies and Alzheimer's disease
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DOI：
10.1007/s004010100415
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发表时间：
2001-12-01
影响因子：
12.7
通讯作者：
Hulette, CM
中科院分区：
文献类型：
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作者：
Rosenberg, CK;Cummings, TJ;Hulette, CM
为了研究阿尔茨海默病（AD）和路易体痴呆（DLB）之间的相似性和差异，我们对来自Kathleen Price Bryan Brain Bank的277例生前诊断为可能AD的患者进行了人口统计学分析。从分析中排除了具有其他可能混淆的临床和病理诊断（如梗死、血肿、肿瘤和其他神经退行性疾病）的患者。神经病理学上，192例受试者（69%）仅存在AD，85例受试者（31%）存在DLB。所有的DLB病例都有AD的神经病理学证据，足以满足CERAD诊断明确AD加黑质路易体的标准。比较两组患者的性别、载脂蛋白E（APOE）基因型、脑重、死亡年龄、病程及Braak分期。使用Fisher精确检验比较分类数据，使用Student t检验比较连续结局的平均值，进行统计分析。在AD和DLB合并人群中，男性和女性的比例平衡。患有DLB的男性中APOE 3/4的频率在统计学上显著增加（P=0.007）。我们发现DLB男性的脑重量高于AD男性（P=0.012）。AD在女性中更常见，DLB在男性中更常见（P=0.019）。我们的研究结果与死亡的年龄，疾病的持续时间和诊断组内的Braak阶段证实了以前报道的结果。这些数据表明，路易体在患有痴呆症的男性中更常见，尤其是那些具有APOE 3/4基因型的男性。
To investigate similarities and differences between Alzheimer's disease (AD) and dementia with Lewy bodies (DLB), we undertook a demographic analysis of 277 patients from the Kathleen Price Bryan Brain Bank with an antemortem diagnosis of probable AD. Patients with additional, possibly confounding clinical and pathologic diagnoses such as infarcts, hematomas, neoplasms, and other neurodegenerative disorders, were excluded from the analysis. Neuropathologically, AD alone was present in 192 subjects (69%), and DLB was found in 85 subjects (31%). All of the DLB cases had neuropathologic evidence of AD sufficient to meet CERAD criteria for a diagnosis of definite AD plus nigral Lewy bodies. Gender, apolipoprotein E (APOE) genotype, brain weight, age at death, duration of disease and Braak stage were compared between the two groups. Statistical analyses were performed using Fisher's exact test for comparisons of categorical data and Student's t-test for comparison of means for continuous outcomes. The proportion of males and females was balanced in the combined AD and DLB populations. There was a highly statistically significant increased frequency of APOE 3/4 in males with DLB (P=0.007). We found higher brain weights in males with DLB versus males with AD (P=0.012). AD was more frequent in females and DLB was more frequent in males (P=0.019). Our findings with respect to age at death, duration of disease and Braak stage within diagnostic groups confirm previously reported findings. These data suggest that Lewy bodies are more common in males affected with dementia, especially those with the APOE 3/4 genotype.