Alzheimer disease
Alzheimer disease
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DOI：
10.1016/b978-0-12-802395-2.00023-7
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发表时间：
2018-01-01
期刊：
影响因子：
2.3
通讯作者：
Duyckaerts, Charles
中科院分区：
文献类型：
--
作者：
Calderon-Garciduenas, Ana Laura;Duyckaerts, Charles
阿尔茨海默病神经病理学的特征在于A β肽的细胞外积累和过度磷酸化的tau的细胞内聚集。随着疾病的进展，肉眼可见的萎缩影响内嗅区和海马、杏仁核和新皮质的相关区域。蓝斑色素脱失。A β的沉积首先由扩散沉积物组成。淀粉样蛋白局灶性沉积物构成老年斑的核心，老年斑还包括tau阳性神经突的冠。在新皮质、海马、纹状体、中脑、最后在小脑以及脑桥核（塔尔期）中连续发现β沉积物。Tau病理以刻板的顺序影响脑干、内嗅区、海马和新皮质的一些特定核-首先是联合区，其次是初级皮质（Braak阶段）。突触的丧失与tau和A β病理学相关;神经元丧失发生在最受影响的区域。颗粒空泡变性和体周颗粒也与阿尔茨海默病病理学有关。阿尔茨海默病的病理生理学仍不清楚。家族性病例表明，A β沉积是最初的步骤，但tau病理学在病程早期出现，似乎与症状更相关。
Alzheimer disease neuropathology is characterized by the extracellular accumulation of A beta peptide and intracellular aggregation of hyperphosphorylated tau. With the progression of the disease, macroscopic atrophy affects the entorhinal area and hippocampus, amygdala, and associative regions of the neocortex. The locus coeruleus is depigmented. The deposition of A beta is first made of diffuse deposits. Amyloid focal deposits constitute the core of the senile plaque which also comprises a corona of tau-positive neurites. A beta deposits are found successively in the neocortex, the hippocampus, the striatum, the mesencephalon, and finally the cerebellum together with the pontine nuclei (Thal phases). Tau pathology affects in a stereotyped order some specific nuclei of the brainstem, the entorhinal area, the hippocampus, and the neocortex - first the associative areas and secondarily the primary cortices (Braak stages). Loss of synapses is observed in association with tau and A beta pathology; neuronal loss occurs in the most affected areas. Granulovacuolar degeneration and perisomatic granules are also linked to Alzheimer disease pathology. The physiopathology of Alzheimer disease remains unknown. Familial cases suggest that A beta\ deposition is the initial step, but tau pathology appears early in the course and seems to be better correlated with the symptoms.