Morrison J H, Hof P R, Bouras C
Fishberg Research Center for Neurobiology, Mount Sinai School of Medicine, New York, New York 10029.
Ann N Y Acad Sci. 1991;640:36-43. doi: 10.1111/j.1749-6632.1991.tb00187.x.
During a recent clinical and neuropathologic evaluation of a large population of brains collected at autopsy, attention was drawn to a subset of Alzheimer's disease (AD) patients presenting with prominent visual symptomatology as the first sign of the disease. In this population, a shift in the distribution of pathologic profiles had occurred such that the primary visual areas and the visual association areas had an increased number of lesions, whereas the prefrontal cortex had fewer lesions than usually observed in AD. Previous quantitative analyses have shown that generally in AD, primary sensory cortical areas are less damaged than association areas of the frontal and temporal lobes, as demonstrated by the laminar and regional distribution of two neuropathologic hallmarks of the disease, neurofibrillary tangles and neuritic plaques. Furthermore, the distribution of pathologic lesions in the AD cases with visual symptomatology revealed the disruption of specific visual association pathways, which are normally affected to a lesser degree in AD. These data suggest that in some cases of AD, the particular psychologic and neurologic symptomatology may be caused by the selective loss of specific corticocortical systems, as reflected by a differential distribution of the neuropathologic markers of the disease.
在最近对大量尸检收集的大脑进行的临床和神经病理学评估中，人们注意到一部分阿尔茨海默病（AD）患者以突出的视觉症状作为该病的首发症状。在这一群体中，病理特征的分布发生了变化，使得初级视觉区域和视觉联合区域的病变数量增加，而前额叶皮质的病变比AD中通常观察到的要少。先前的定量分析表明，一般在AD中，初级感觉皮质区域的受损程度低于额叶和颞叶的联合区域，这一点已通过该疾病的两个神经病理学特征——神经原纤维缠结和神经炎性斑块的层状和区域分布得到证明。此外，有视觉症状的AD病例中病理病变的分布揭示了特定视觉联合通路的破坏，而在AD中这些通路通常受到的影响较小。这些数据表明，在某些AD病例中，特定的心理和神经症状可能是由特定皮质皮质系统的选择性丧失引起的，这反映在该疾病神经病理学标志物的差异分布上。
