Corder E H, Woodbury M A, Volkmann I, Madsen D K, Bogdanovic N, Winblad B
Center for Demographic Studies, 2117 Campus Drive, Duke University, Durham, NC 27708-0408, USA.
Exp Gerontol. 2000 Sep;35(6-7):851-64. doi: 10.1016/s0531-5565(00)00147-9.
Density profiles of Alzheimer's disease (AD) regional brain pathology were constructed for 249 subjects in the Huddinge Brain Bank. Counts per square millimeter for neurofibrillary tangles (NFT), diffuse plaques (DP), and neuritic plaques (NP) in 38 areas were investigated using a pattern recognition technique called GoM. The seven distributional profiles of AD neuropathology emulated and expanded upon Braak staging illustrating induction (Groups 1-3) and clinical progression (Groups 4-7). Normal aging represented limited AD changes, few NFT in the entorhinal cortex and hippocampal CA1 (Group 1). The threshold for possible AD was NFT in the subiculum (Group 2), found with DP in the neocortex. Temporal medial NFT was the threshold for probable AD (Group 4). The 'oldest-old', often demented without brain atrophy, had extensive entorhinal/CA1 NFT and cortical DP, but few cortical NFT or NP (Group 5). A second subtype 'disconnection' (Group 6) lacked AD pathology for a specific set of subcortical and cortical areas. Accumulation of NFT in first-affected areas continued through end-stage disease (Group 7), with apparent rapid transition of DP to NP in the cortex during clinical progression. The evolution of AD is a highly ordered sequential process. Pattern recognition approaches such as GoM may be useful in better defining the process.
构建了胡丁厄大脑银行中249名受试者的阿尔茨海默病（AD）区域脑病理学密度分布图。使用一种名为GoM的模式识别技术，研究了38个区域中神经原纤维缠结（NFT）、弥漫性斑块（DP）和神经炎斑块（NP）每平方毫米的计数。AD神经病理学的七种分布模式模仿并扩展了Braak分期，说明了诱导期（1-3组）和临床进展期（4-7组）。正常衰老表现为有限的AD变化，在内嗅皮质和海马CA1区有少量NFT（1组）。可能患有AD的阈值是下托出现NFT（2组），同时在新皮质中发现DP。颞叶内侧NFT是可能患有AD的阈值（4组）。“最年长者”通常患有痴呆但无脑萎缩，有广泛的内嗅皮质/CA1区NFT和皮质DP，但皮质NFT或NP较少（5组）。第二种亚型“失连接型”（6组）在一组特定的皮质下和皮质区域缺乏AD病理学特征。在疾病终末期，最初受影响区域的NFT持续累积（7组），在临床进展过程中，皮质中的DP明显迅速转变为NP。AD的演变是一个高度有序的连续过程。像GoM这样的模式识别方法可能有助于更好地定义这一过程。
