Empiric refinement of the pathologic assessment of Lewy-related pathology in the dementia patient
Empiric refinement of the pathologic assessment of Lewy-related pathology in the dementia patient
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DOI：
10.1111/j.1750-3639.2007.00117.x
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发表时间：
2008-04-01
期刊：
影响因子：
6.4
通讯作者：
Montine, Thomas J.
中科院分区：
文献类型：
--
作者：
Leverenz, James B.;Hamilton, Ronald;Montine, Thomas J.
路易相关病理（LRP）是一种常见的病理发现在尸检痴呆患者。最近发表了对痴呆患者LRP类型进行分类的标准，尽管这些标准尚未系统地应用于大型痴呆样本。我们检查了大量（n = 208）基于转诊的LRP尸检样本，并将已发表的LRP分类标准应用于这些病例。我们发现该样本中几乎一半（49%）的LRP阳性病例无法分类。然而，通过减少需要检查的区域数量来修改公布的标准，允许特定脑区域内LRP严重程度评分的更多可变性，并增加杏仁核主导类别，允许从转诊样本中分类97%的LRP阳性病例。将修改后的标准应用于一个不相关的社区尸检样本（n = 226）， 96%的LRP阳性病例得以分类。对已公布的标准进行适度修改，可以将更多的LRP痴呆病例进行分类。此外，这种修改允许对LRP分类的大脑区域进行更有限的采样。我们建议这些修改后的LRP分类标准可用于有痴呆病史的患者。
Lewy-related pathology (LRP) is a common pathologic finding at autopsy in dementia patients. Recently criteria for categorizing types of LRP in dementia patients were published, though these criteria have yet to be systematically applied to large dementia samples. We examined a large (n = 208) referral-based autopsy sample for LRP, and applied the published criteria for LRP categorization to these cases. We found almost half (49%) of LRP positive cases from this sample were not classifiable. However, modifying the published criteria by reducing the number of regions requiring examination, allowing more variability in LRP severity scores within specific brain regions, and adding an amygdala predominant category permitted classification of 97% of LRP positive cases from the referral-based sample. Application of the modified criteria to an unrelated community-based autopsy sample (n = 226) allowed classification of 96% of LRP positive cases. Modest modifications in the published criteria permit a significantly greater number of dementia cases with LRP to be classified. In addition, this modification allows for more limited sampling of brain regions for classification of LRP. We propose that these modified criteria for the categorization of LRP be utilized in patients with a history of dementia.