Harasty J A, Halliday G M, Kril J J, Code C
Prince of Wales Medical Research Institute, Randwick, NSW, Australia.
Brain. 1999 Apr;122 ( Pt 4):675-86. doi: 10.1093/brain/122.4.675.
The aim of this study was to determine the topography and degree of atrophy in speech and language-associated cortical gyri in Alzheimer's disease. The post-mortem brains of 10 patients with pathologically confirmed Alzheimer's disease and 21 neurological and neuropathological controls were sectioned in serial 3 mm coronal slices and grey and white matter volumes were determined for specific cortical gyri. All Alzheimer's disease patients had prospectively documented impairments in verbal and semantic memory with concomitant global decline. The cortical regions of interest included the planum temporale, Heschl's gyri, the anterior superior temporal gyri, the middle and inferior temporal gyri, area 37 at the inferior temporoparietal junction, areas 40 and 39 (supramarginal and angular gyri) and Broca's frontal regions. Although most patients had end-stage disease, the language-associated cortical regions were affected to different degrees, with some regions free of atrophy. These included Broca's regions in the frontal lobe and Heschl's gyri on the superior surface of the temporal lobe. In contrast, the inferior temporal and temporoparietal gyri (area 37) were severely reduced in volume. The phonological processing regions in the superior temporal gyri (the planum temporale) were also atrophic in all Alzheimer's disease patients while the anterior superior temporal gyri were only atrophic in female patients. Such atrophy may underlie the more severe language impairments previously described in females with Alzheimer's disease. The present study is the first to analyse the volumes of language-associated gyri in post-mortem patients with confirmed Alzheimer's disease. The results show that atrophy is not global but site-specific. Atrophied gyri appear to reflect a specific network of language and semantic memory dissolution seen in the clinical features of patients with Alzheimer's disease. Females showed greater atrophy than males in the anterior superior temporal gyri.
本研究的目的是确定阿尔茨海默病中与言语和语言相关的皮质脑回的形态及萎缩程度。对10例经病理证实为阿尔茨海默病的患者以及21例神经学和神经病理学对照者的尸检大脑进行连续3毫米冠状切片，并测定特定皮质脑回的灰质和白质体积。所有阿尔茨海默病患者均有前瞻性记录的言语和语义记忆障碍，并伴有整体衰退。感兴趣的皮质区域包括颞平面、颞横回、颞上回前部、颞中回和颞下回、颞顶叶交界处的37区、40区和39区（缘上回和角回）以及布洛卡区。尽管大多数患者处于疾病终末期，但与语言相关的皮质区域受到不同程度的影响，有些区域未出现萎缩。这些区域包括额叶的布洛卡区和颞叶上表面的颞横回。相比之下，颞下回和颞顶叶脑回（37区）体积严重减小。所有阿尔茨海默病患者颞上回（颞平面）中的语音处理区域也出现萎缩，而颞上回前部仅在女性患者中出现萎缩。这种萎缩可能是先前所述女性阿尔茨海默病患者语言障碍更严重的原因。本研究首次分析了经证实患有阿尔茨海默病的尸检患者中与语言相关脑回的体积。结果表明，萎缩并非全身性的，而是部位特异性的。萎缩的脑回似乎反映了阿尔茨海默病患者临床特征中所见的特定语言和语义记忆解体网络。女性颞上回前部的萎缩比男性更严重。
