Differences in neuropathologic characteristics across the Lewy body dementia spectrum
Differences in neuropathologic characteristics across the Lewy body dementia spectrum
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DOI：
10.1212/01.wnl.0000249130.63615.cc
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发表时间：
2006-12-12
期刊：
影响因子：
9.9
通讯作者：
Aarsland, D.
中科院分区：
文献类型：
--
作者：
Ballard, C.;Ziabreva, I.;Aarsland, D.
背景资料：这项比较神经病理学研究的目的是确定路易体痴呆（DLB）和帕金森病痴呆（PDD）在帕金森综合征持续时间方面是不同实体或连续体的一部分的程度。研究方法：我们在57例前瞻性评估的患者（29例DLB，28例PDD）中评估了皮质α-突触核蛋白病理学、斑块（建立阿尔茨海默病登记处协会[CERAD]）、缠结（Braak分期）和胆碱能缺陷（颞叶皮质胆碱乙酰转移酶）之间的关系，这些患者在尸检时得到证实。PDD组根据痴呆前帕金森病的中位持续时间进行划分。结果如下：痴呆前帕金森综合征持续时间较长与皮质α-突触核蛋白病理学较轻（chi（2）10. 4，df 2，p = 0. 006）和CERAD斑块评分较低（chi（2）26. 6，df 9，p = 0. 002）之间存在相关性，但与Braak分期无关。这些发现在进一步的相关性分析中得到了证实，该分析还发现了更明显的皮质胆碱能缺陷与痴呆前帕金森病持续时间更长之间存在意想不到的相关性（R =-0.37，p = 0.04）。结论：虽然在痴呆发作之前帕金森病的持续时间与关键的神经病理学和神经化学特征之间存在明确的关系，但在路易体痴呆/帕金森病痴呆谱中存在这些差异的分级，并且研究结果不支持两种疾病之间的任意截止。
Background: The objective of this comparative neuropathologic study was to determine the extent to which dementia with Lewy bodies (DLB) and Parkinson disease dementia (PDD) are distinct entities or part of a continuum with respect to the duration of parkinsonism. Methods: We evaluated the relationship between cortical alpha-synuclein pathology, plaques (Consortium to Establish a Registry for Alzheimer's Disease [CERAD]), tangles (Braak staging), and cholinergic deficits ( choline acetyltransferase in temporal cortex) in 57 prospectively assessed patients ( 29 DLB, 28 PDD), confirmed at autopsy. The PDD group was divided according to the median duration of parkinsonism prior to dementia. Results: There was an association between longer duration of parkinsonism prior to dementia and less severe cortical alpha-synuclein pathology (chi(2) 10.4, df 2, p = 0.006) and lower CERAD plaque scores (chi(2) 26.6, df 9, p = 0.002), but not Braak staging. These findings were confirmed in a further correlation analysis, which also identified an unexpected correlation between more pronounced cortical cholinergic deficits and longer duration of parkinsonism prior to dementia (R = -0.37, p = 0.04). Conclusion: While there is a clear relationship between the duration of Parkinson disease prior to the onset of dementia and key neuropathologic and neurochemical characteristics, there is a gradation of these differences across the dementia with Lewy bodies/Parkinson disease dementia spectrum and the findings do not support an arbitrary cut-off between the two disorders.