权益分类	功能权益	普通用户	{{item.name}}会员
{{category.name}}	{{benefitItem.name}}

Psychiatric symptoms as preceding or early signs of dementia of Alzheimer type. A cohort study.

精神症状是阿尔茨海默型痴呆的前期或早期症状。

基本信息

批准号：
14570957
负责人：
AKIYAMA Haruhiko
金额：
$ 1.34万
依托单位：
Tokyo Metropolitan Organization for Medical Research
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
2002
资助国家：
日本
起止时间：
2002 至 2005
项目状态：
已结题

项目摘要

In total of 188 Alzheimer's disease (AD) patients (51 men and 137 women), who were admitted to Tokyo Metropolitan Matsuzawa Hospital, 13.1% of female patients and 2% of male patients had hallucination and/or delusion as early symptoms of the disease. The male patients also tended to have abnormal behavior or depression. Patients with AD type dementia, who show depression, hallucination or delusion as early symptoms, are often diagnosed neuropathologically as dementia with Lewy bodies (DLB). The vast majority of DLB patients had heavy accumulation of amyloid beta protein (Aβ) and neurofibrillary changes in the limbic cortices similarly to AD patients. On the other hand, those who do not fulfill the criteria for DLB and are, thus, diagnosed as AD, often have mild Lewy body pathology. It seems that the occurrence of psychiatric symptoms in dementia of AD type is related to the overlap between AD lesions and DLB lesions. However, thinking of these two diseases in a single entity or a group of diseases, a yet unsolved question is paucity of neurofibrillary changes in the neocortex of DLB, which seems to be unproportionate to the degree of Aβ deposits. In this study, we have demonstrated heavy accumulation of α-synuclein in the neuronal processes in the neocortex of DLB by immunohistochemistry of postmortem brain tissues from DLB patients using the antibodies to phosphorylated α-synuclein. Quantitative analyses have indicated that the amount of neuritic α-synuclein accumulation in DLB is comparable with that of neuritic tau accumulation in AD. The total of neuritic α-synuclein and tau accumulation is proportionate to the degree of Aβ deposits regardless of the cases is DLB or AD. Aβ may promote accumulation of not only tau but also α-synuclein. We speculate that, if the process is shifted toward tau accumulation, the manifestation becomes AD, and, if it is shifted toward α-synuclein accumulation, the manifestation becomes DLB

在东京都立松泽医院收治的188名阿尔茨海默病（AD）患者（男性51名，女性137名）中，13.1%的女性患者和2%的男性患者的幻觉和/或妄想作为疾病的早期症状。男性患者也倾向于有异常行为或抑郁。AD型痴呆患者以抑郁、幻觉或妄想为早期症状，常被神经病理学诊断为路易体痴呆（DLB）。绝大多数DLB患者与AD患者相似，边缘皮质中存在淀粉样β蛋白（Aβ）的大量积聚和神经病理学改变。另一方面，那些不符合DLB标准并因此被诊断为AD的人通常具有轻度路易体病理。提示AD型痴呆患者精神症状的发生与AD病灶与DLB病灶重叠有关。然而，考虑到这两种疾病在一个实体或一组疾病中的存在，一个尚未解决的问题是DLB的新皮质中缺乏神经病理学变化，这似乎与Aβ沉积的程度不成比例。在这项研究中，我们通过使用磷酸化α-突触核蛋白的抗体对DLB患者的死后脑组织进行免疫组织化学染色，证明了DLB新皮层神经元突起中α-突触核蛋白的大量积聚。定量分析表明，DLB中神经炎性α-突触核蛋白积累的量与AD中神经炎性tau积累的量相当。无论病例是DLB还是AD，神经炎性α-突触核蛋白和tau累积的总量与Aβ沉积的程度成比例。Aβ不仅可以促进tau蛋白的积累，还可以促进α-突触核蛋白的积累。我们推测，如果该过程转向tau积累，则表现为AD，如果转向α-突触核蛋白积累，则表现为DLB