CLINICOPATHOLOY OF DEMENTIA SYMPTOMS N ALZHEIMER'S DISEASE : A MORPHOMETRIC STUDY IN THE HIPPOCAMPAL LESIONS

海马皮层（海马结构和海马旁回）是记忆系统的关键结构，也是阿尔茨海默病（AD）的主要受累区域。为了更全面地探索阿尔茨海默病中痴呆症状如记忆障碍与海马皮质中通过神经元变性引起的神经元死亡之间的临床病理学关系，对22名具有不同病程的患者的海马皮质的8个亚区中未受影响的神经元、细胞内神经元缠结（i-NFT）和细胞外NFT（e-NFT）进行形态计量学评估，使用Gallyas苏木精-伊红染色。研究的亚部包括CA 1 -4、前下托（PRO）、下托和前下托（PRE）、旁下托（帕拉）和内嗅皮层（ENT）。在AD患者中，除PRE外，未受影响的神经元密度与e-NFT密度和总NFT密度呈显著负相关。尤其是在CA 2、CA 1、PRO和ENT，神经元密度与这些NFT密度之间有很强的相关性。CA 1和ENT中未受影响的神经元和e-NFT密度与疾病持续时间显著相关。i/e-NFT比值是通过神经元变性导致神经元死亡的程度和/或进展速度的指标，在AD患者的ENT中显示出最低值。结果表明，神经元变性引起的神经元死亡在ENT中开始最早和/或进展最快。此外，ENT和CA 1中的i/e-NFT比值与疾病持续时间显著相关，提示这两个亚类中的连续神经元死亡模式与AD的疾病进展平行。通过ENT和海马皮质中的CA 1的神经元变性的神经元死亡可能有助于病理性AD的发生。AD中记忆障碍的基质。

Hippocampal cortex (hippocampal formation and parahippocampal gyrus) is a key structure of the memory system and is most affected region in Alzheimer's disease (AD). To explore more fully the clinicopathological relationship between dementia symptoms such as memory disturbance and neuronal death via neurofibrillary degeneration in the hippocampal cortex in Alzheimer's disease, unaffected neurons, intracellular neurofibrillary tangles (i-NFTs) and extracellular NFTs (e-NFTs) in 22 patients with the different disease duration were morphometrically evaluated in 8 subdivisions of the hippocampal cortex, using the Gallyas hematoxylin-eosin stain. The subdivisions examined included CA1-4, prosubiculum (PRO), subiculum and presubiculum (PRE), parasubiculum (PARA) and the entorhinal cortex (ENT). Unaffected neuron density was significantly, inversely correlated with e-NFT density and with total NFT density in all subdivisions except for PRE in AD patients. Especially in CA2, CA1, PRO and ENT, there were strong correlations between the neuron density and these NFT densities. Both unaffected neuron and e-NFT densities in CA1 and ENT were significantly correlated with the disease duration. The i/e-NFT ratio, an index of the degree and/or rate of progress of neuronal death via neurofibrillary degeneration, showed the lowest value in ENT in AD patients. The findings suggest neuronal death via neurofibrillary degeneration starts earliest and/or most rapidly progresses in ENT.Furthermore, the i/e-NFT ratios in both ENT and CA1 were significantly correlated with the disease duration, suggesting that continuous neuronal death pattern in the two subdivisions parallels disease progression in AD.Neuronal death via neurofibrillary degeneration in ENT and CA1 in the hipocampal cortex may contribute to pathological substrate of memory disturbance in AD.