The autonomic-related cortex: Pathology in Alzheimer's disease
The autonomic-related cortex: Pathology in Alzheimer's disease
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DOI：
10.1093/cercor/7.1.86
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发表时间：
1997-01-01
期刊：
影响因子：
3.7
通讯作者：
VanHoesen, GW
中科院分区：
文献类型：
--
作者：
Chu, CC;Tranel, D;VanHoesen, GW
阿尔茨海默病（AD）导致认知和行为的进行性恶化。记忆功能障碍是AD的标志，但也有行为、情绪和自主神经功能的变化，这不能简单地解释为记忆障碍的结果。这些观察结果表明，AD的自然疾病过程不仅涉及与记忆相关的神经结构，还涉及与其他行为、情绪和自主神经功能相关的特定神经系统。由于最近的证据表明，主要作用远腹内侧额叶（VWF）皮层在这样的功能，我们研究了层状分布的神经纤维缠结和Alz 50免疫反应阳性神经元在20例AD患者和7个年龄匹配的对照VMF皮层的分区。病理改变的密度：（i）后内侧皮质中区最高，尤其是Brodmann 'sarea 25（A25）、后眶额皮质（POF）和前额叶皮质（A1），（ii）后内侧皮质中区与大多数颞叶皮质（除内嗅皮质和颞极外）的病变密度相当;进一步的分析表明，A25、POF和A1的V层中的选择性病理会破坏直接的皮质-自主神经投射。这是第一项详细描述这些与大脑皮层相关的严重AD病理学的研究，这些病理学可能导致行为变化、情绪障碍和自主神经失调，这些通常伴随着AD。
Alzheimer's disease (AD) causes progressive deterioration of cognition and behavior. Memory dysfunction is the hallmark but there are also changes in behavior, emotion and autonomic functions, which cannot he explained simply as a consequence of memory impairment These observations suggest that the natural disease process of AD involves not only memory-related neural structures, but also specific neural systems related to other behaviors, emotion and autonomic functions. Since recent evidence has indicated a primary role far ventromedial frontal (VWF) cortex in such functions, we examined laminar distribution of neurofibrillary tangles and Alz 50 immunoreactive neurons in subdivisions of VMF cortex in 20 AD patients and seven age-matched controls. The densities of pathological changes were: (i) highest in the posteromedial mesocortical regions, particularly Brodmann's area 25 (A25), posterior orbitofrontal cortex (POF) and anterior insula (Al); (ii) of comparable severity between posteromedial mesocortical regions and most temporal cortices, excluding only the entorhinal cortex and temporal pole; and (iii) located predominantly in layer III and especially layer V. Further analysis demonstrated selective pathology in layer V of A25, POF and Al that would disrupt direct cortico-autonomic projections. This is the first study to detail severe AD pathology in these autonomic-related cortices, which could contribute to the behavioral changes, emotional disturbance and autonomic dysregulation that often accompany AD.