CLINICAL CORRELATES OF CORTICAL AND NUCLEUS BASALIS PATHOLOGY IN ALZHEIMER DEMENTIA
CLINICAL CORRELATES OF CORTICAL AND NUCLEUS BASALIS PATHOLOGY IN ALZHEIMER DEMENTIA
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DOI：
10.1001/archneur.1994.00540200048015
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发表时间：
1994-08-01
影响因子：
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通讯作者：
MASLIAH, E
中科院分区：
文献类型：
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作者：
SAMUEL, W;TERRY, RD;MASLIAH, E
目的：探讨阿尔茨海默病痴呆的严重程度与皮层和皮层下脑区神经病理程度的相关性。方法：在13例阿尔茨海默病患者死亡前进行神经心理测试，我们评估了中额叶皮层和Meynert基底核的神经原纤维缠结、老年斑、神经元和突触密度。结果：在中额叶皮层，突触密度与痴呆严重程度的相关性最强，其次是神经原纤维缠结。相比之下，在基底核，神经原纤维缠结是最强的，其次是突触密度。逐步回归分析显示，中额叶突触密度是强调高级皮层功能的测试的最强预测因子，而基底核的神经原纤维缠结是记忆导向测试的最强预测因子。结论：皮层和皮层下部位的病理特异性预测神经心理缺陷的特定质量可能反映了皮质-皮质连接的破坏与基底前脑胆碱能系统的紊乱。
Objective: We correlated severity of dementia in Alzheimer's disease with the degree of neuropathology in cortical and subcortical brain regions.Methods: In 13 patients with Alzheimer's disease who underwent neuropsychological testing before death, we assessed neurofibrillary tangles, senile plaques, and neuronal and synaptic density in the midfrontal cortex and the nucleus basalis of Meynert.Results: In the midfrontal cortex, synapse density was the strongest correlate of dementia severity, followed by neurofibrillary tangles. In the nucleus basalis, by contrast, neurofibrillary tangles were the strongest corre-late, followed by synapse density. Stepwise regression analyses showed midfrontal synapse density to be the strongest predictor of tests emphasizing higher cortical functions, but neurofibrillary tangles in the nucleus basalis were the strongest predictor on memory-oriented tests.Conclusions: The specificity of pathology in cortical vs subcortical locations for predicting a particular quality of neuropsychological deficit probably reflects disruption of corticocortical connections vs derangement of the basal forebrain cholinergic system.