Clinicopathological study of dementia : the Hisayama study

Hisayama研究是在日本郊区社区Hisayama Town进行的一项前瞻性基于人群的临床病理队列研究。大多数死者都经过尸检，以确认死因并检查脑部病理学。这些功能允许一个可靠的估计频率的神经退行性疾病相关的痴呆症在一般人群中，并详细分析痴呆症和非痴呆症之间的差异。在这项研究中，我们获得了以下发现。(1)We神经元缠结型老年痴呆（SD-NFT）占第四位（3.9%）。我们发现，SD-NFT患者海马NFT的数量并不一定超过阿尔茨海默病的程度，并且脑重量明显降低，其程度与阿尔茨海默病（AD）相同，这表明不仅边缘系统NFT病理，而且一些全脑功能障碍也可能导致SD-NFT患者的海马NFT数量减少。 ...更多信息 精神退化。(2)To为探讨环氧化酶（考克斯）-2在海马的表达，我们分析了45例连续尸检的非痴呆患者和25例AD患者。考克斯-2在海马CA 3区、下托、内嗅皮质和经内嗅皮质的神经元表达在非痴呆和AD脑中均一致地观察到，并且考克斯-2免疫反应性在非痴呆脑中与年龄相关。AD患者海马CA 1区考克斯-2阳性神经元的表达与AD的严重程度相关，而非痴呆组则无明显相关性。结果表明，考克斯-2的表达可能是不同的调节之间的细分的海马和升高的考克斯-2的表达在CA 1的AD大脑可能与AD的病理，从而认知功能障碍。（3）路易体痴呆（DLB）是第三大痴呆。为了验证2005年修订的标准的有效性，我们分析了205例连续的痴呆尸检病例。59例（28.8%）存在LB病理。女性DLB病例有更严重的LB病理和阿尔茨海默型病理的趋势。高可能性病例和中等可能性病例分别平均表现出3个临床核心特征中的0.44个和0.94个。另一方面，低可能性病例和LB阴性病例分别仅显示0.19和0.18。总之，它是适当的，包括高可能性和中间的情况下诊断DLB。少

The Hisayama study is a prospective population-based clinicopathological cohort in a Japanese subrural community, Hisayama Town. Most deceased subjects have been examined by autopsy to confirm causes of death and to examine brain pathology. These features have allowed a reliable estimation of the frequency of neurodegenerative diseases relating dementia in a general population and for a detailed analysis of the difference between dementia and non-dementia. In this study we obtained following findings.(1)We have estimated the frequency of senile dementia of the neurofibrillary tangle type (SD-NFT), which was fourth frequent type of dementia (3.9%). We found that the number of NFTs in the hippocampus of SD-NFT cases did not necessarily exceed the degree of those in Alzheimer's disease and that total brain weights were significantly reduced to the same extent as Alzheimer's disease (AD), which suggest that not only the limbic NFT pathology but also some whole brain dysfunctions might caus … More e the mental deterioration.(2)To explore cyclooxygenase(COX)-2 expression in the hippocampus, we analyzed 45 consecutive autopsy subjects without dementia and 25 AD patients. The neuronal expression of COX-2 in the CA3 subdivision of the hippocampus, subiculum, entorhinal cortex and transentorhinal cortex were consistently observed in both non-demented and AD brains and COX-2 immunoreactivity correlated with age in non-demented brains. In AD patients, neurons of CA1 exhibited increased COX-2 immunoreactivity which correlated with the severity of AD pathology, this correlation was not apparent in non-demented subjects. The results suggest that COX-2 expression may be differentially regulated among subdivisions of the hippocampus and that elevated COX-2 expression in the CA1 of AD brains may be associated with AD pathology and thus cognitive dysfunction.(3)Dementia with Lewy bodies (DLB) ranks the third major dementia. To verify the validity of the revised criteria in 2005, we have analyzed 205 consecutive demented autopsy cases. LB pathology was present in 59 cases (28.8%). Female cases with DLB have a tendency for more severe LB pathology and Alzheimer-type pathology as well. The high likelihood cases and intermediate cases exhibited 0.44 and 0.94 of 3 clinical core features each on average, respectively. On the other hand, the low likelihood cases and the LB-negative cases showed only 0.19 and 0.18 each. In conclusion, it is appropriate to include both the high likelihood and intermediate cases for diagnosis of DLB. Less