Quantitative analysis of neurofibrillary pathology in a general population to reappraise neuropathological criteria for senile dementia of the neurofibrillary tangle type (tangle‐only dementia): The Hisayama study
Quantitative analysis of neurofibrillary pathology in a general population to reappraise neuropathological criteria for senile dementia of the neurofibrillary tangle type (tangle‐only dementia): The Hisayama study
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DOI：
10.1111/j.1440-1789.2006.00722.x
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发表时间：
2006-12
期刊：
影响因子：
2.3
通讯作者：
K. Noda;K. Sasaki;Kohei Fujimi;Y. Wakisaka;Yumihiro Tanizaki;Y. Wakugawa;Y. Kiyohara;M. Iida;H. Aizawa;T. Iwaki
中科院分区：
文献类型：
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作者：
K. Noda;K. Sasaki;Kohei Fujimi;Y. Wakisaka;Yumihiro Tanizaki;Y. Wakugawa;Y. Kiyohara;M. Iida;H. Aizawa;T. Iwaki
神经元缠结型老年性痴呆（SD‐NFT）的特征在于海马区存在大量神经元缠结（NFT），整个大脑中不存在或存在极少量老年斑。我们分析了Hisayama研究中尸检的207例痴呆受试者和68例非痴呆受试者，以研究一般日本人群中SD-NFT的临床病理学方面。在连续尸检病例中，SD‐NFT的患病率为8/207（3.9%），包括3名男性和5名女性。发病和死亡时的平均年龄分别为83.8 ± 6.8岁（平均值± SD;标准差）和88.1 ± 7.6岁。轻度记忆障碍先于日常生活活动能力下降和痴呆诊断。任何受试者在病程期间均未出现局灶性脑症状，如失语和瘫痪。脑部大体检查显示中度至重度弥漫性脑萎缩伴脑重量减轻（平均值± SD;标准差：1118.1 ± 124.0 g）。组织学上，有丰富的NFT和神经纤维的线程主要在或局限于边缘皮质。SD‐NFT中CA 1/下托中的NFT密度远高于海马其他区域中的密度。在SD‐NFT受试者中，CA 1中NFT的平均密度为115.4/100×视野（范围23-247），阿尔茨海默病（AD）受试者为80.1（范围1-227），非痴呆老年受试者为37.2（范围0-203）。尽管许多先前的论文已经报道了SD-NFT中边缘系统中的NFT密度显著高于AD中的NFT密度，但在非痴呆老年人、AD受试者和SD-NFT受试者中，CA 1中的NFT密度存在相当大的重叠。
Senile dementia of the neurofibrillary tangle type (SD‐NFT) is characterized by numerous neurofibrillary tangles (NFT) in the hippocampal region and the absence or minimal presence of senile plaques throughout the brain. We analyzed 207 demented subjects and 68 non‐demented subjects autopsied in the Hisayama study to investigate the clinicopathological aspects of SD‐NFT in the general Japanese population. The prevalence of SD‐NFT in the consecutive autopsy cases was 8/207 (3.9%), comprising three men and five women. The average age at onset and death was 83.8 ± 6.8 (mean ± SD; standard deviation) and 88.1 ± 7.6 years, respectively. A mild memory disturbance preceded a decrease in the ability to undertake the activities of daily living and the diagnosis of dementia. Focal cerebral symptoms, such as aphasia and paralysis, did not appear during the disease course of any subject. Gross examination of the brains showed moderate to severe diffuse cerebral atrophy with brain weight loss (mean ± SD; standard deviation: 1118.1 ± 124.0 g). Histologically, there were abundant NFT and neuropil threads predominantly in or limited to the limbic cortex. The density of NFT in the CA1/subiculum in SD‐NFT was much higher than the densities in the other hippocampal regions. The average density of NFT in CA1 in SD‐NFT subjects was 115.4 per 100× field (range 23–247), that in Alzheimer disease (AD) subjects was 80.1 (range 1–227), and that in non‐demented elderly subjects was 37.2 (range 0–203). Although many previous papers have reported that the densities of NFT in the limbic system in SD‐NFT were significantly higher than those in AD, there was considerable overlap of NFT densities in CA1 among the non‐demented elderly, AD subjects and SD‐NFT subjects.