Van Hoesen G W, Hyman B T, Damasio A R
Department of Anatomy, University of Iowa, Iowa City 52242.
Hippocampus. 1991 Jan;1(1):1-8. doi: 10.1002/hipo.450010102.
The anatomical distribution of pathological changes in Alzheimer's disease, although highly selective for only certain brain areas, can be widespread at the endstage of the illness and can affect many neural systems. Propriety for onset among these is a question of importance for clues to the etiology of the disease, but one that is formidable without an experimental animal model. The entorhinal cortex (Brodmann's area 28) of the ventromedial temporal lobe is an invariant focus of pathology in all cases of Alzheimer's disease with selective changes that alter some layers more than others. The authors' findings reveal that it is the most heavily damaged cortex in Alzheimer's disease. Neuroanatomical studies in higher mammals reveal that the entorhinal cortex gives rise to axons that interconnect the hippocampal formation bidirectionally with the rest of the cortex. Their destruction in Alzheimer's disease could play a prominent role in the memory deficits that herald the onset of Alzheimer's disease and that characterize it throughout its course.
阿尔茨海默病病理变化的解剖学分布，虽然仅对某些脑区具有高度选择性，但在疾病末期可能广泛存在，并可影响多个神经系统。这些脑区中发病的倾向性对于该疾病病因线索而言是一个重要问题，但在没有实验动物模型的情况下，这是一个艰巨的问题。腹内侧颞叶的内嗅皮质（布罗德曼28区）在所有阿尔茨海默病病例中都是病理学的一个不变焦点，其选择性变化对某些层的影响大于其他层。作者的研究结果表明，它是阿尔茨海默病中受损最严重的皮质。对高等哺乳动物的神经解剖学研究表明，内嗅皮质产生的轴突将海马结构与皮质的其他部分双向互连。它们在阿尔茨海默病中的破坏可能在预示阿尔茨海默病发病并贯穿其病程的记忆缺陷中起重要作用。
