Neuropathology of white matter changes in Alzheimer's disease and vascular dementia
Neuropathology of white matter changes in Alzheimer's disease and vascular dementia
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DOI：
10.1159/000051183
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发表时间：
1998-07-01
影响因子：
2.4
通讯作者：
Englund, E
中科院分区：
文献类型：
--
作者：
Englund, E
研究人员对临床和神经病理学诊断的阿尔茨海默病（AD；60 例）和血管性痴呆（VaD，40 例）病例的白质形态变化进行了研究。在 60 例 AD 病例中，有 33 例出现白质疾病 (WMD)，其特征是组织稀疏、轻度神经胶质增生和非淀粉样小血管硬化，发生在中央、尤其是额叶深部白质。平均血管密度显着低于正常对照病例额叶白质。大规模杀伤性武器的存在与灰质阿尔茨海默脑病的严重程度并不相符。在 60 例 AD 病例中，有 25 例在颞叶高级皮质变性的下方发现了伴有组织成分浓缩和稀疏迹象的白质变性。仅13例符合WMD，被判断为顺行、Wallerian型，与血管病无关。在 VaD 中，也发生了类似的变化，并伴有几种类型的局灶性和地形相关的病变。对于伴有痴呆的血管和神经退行性疾病中具有相似外观的弥漫性白质病理，可能存在多种至少部分相反的病因，在某些情况下甚至可以通过存在甚至较小的局灶性病变来区分。认识到大规模杀伤性武器频谱中的这种微妙变化，现代成像技术对于详细的临床诊断和治疗干预的尝试至关重要。
Morphological white matter changes were investigated in clinically and neuropathologically diagnosed cases of Alzheimer's disease (AD; 60 cases) and vascular dementia (VaD, 40 cases). In 33 of 60 AD cases, a white matter disease (WMD) characterized by tissue rarefaction, mild gliosis and a non-amyloid small-vessel sclerosis occurred in the central, preferentially frontal deep white matter. The mean vessel density was significantly lower than in normal control case frontal white matter. The presence of WMD did not parallel the severity of grey matter Alzheimer encephalopathy. In 25 of 60 AD cases, white matter degeneration with signs of both condensation and rarefaction of tissue elements was seen subjacent to advanced cortical degeneration in the temporal lobes. It concurred with WMD in only 13 cases and was judged to be of anterograde, Wallerian type and not related to angiopathy. In VaD, similar changes occurred, accompanied by several types of focal and topographically related lesions. For diffuse white matter pathology of similar appearance in vascular and neurodegenerative disease with dementia, there may be various at least partly contrasting aetiologies, which can be differentiated by the presence of even minor focal lesions in some cases. For the recognition of such subtle variations in the spectrum of WMD modem imaging techniques are crucial for detailed clinical diagnosis and attempts at therapeutic intervention.