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迈向适用于多种退行性疾病和正常认知的阿尔茨海默病样综合征发病机制和病理生理学的多维表述。

Toward a multi-dimensional formulation of the pathogenesis and pathophysiology of the Alzheimer dementia-like syndrome applicable to a variety of degenerative disorders and normal cognition.

作者信息

Kuljis Rodrigo O

机构信息

Brain-Mind Project, Inc. and Encephalogistics, Inc., 801 East Beach Drive, Suite BC 1608, Galveston, TX 77550, USA.

出版信息

Med Hypotheses. 2009 Sep;73(3):315-8. doi: 10.1016/j.mehy.2009.01.053. Epub 2009 Apr 24.

Abstract

Neurodegenerative disorders constitute a set of heterogeneous conditions lacking a satisfactory unifying conceptual scheme. This situation is widely perceived as hampering progress in understanding them adequately in order to develop effective treatment and prevention, but there is no unanimously or even generally agreed upon solution to this dilemma. Here, we propose that progress in resolving this conundrum requires addressing in an integrated fashion multiple dimensions and scales of organization and (normal and disordered) function that include, but transcend the conventional levels of space, time, Molecular Biology/Biochemistry and Systems Neuroscience, among others. This approach must include also a revision of the nosological concepts that currently attempt to force pathophysiological and etiological explanations within a single domain (nowadays predominantly the Molecular/Biochemical) that have virtually always failed to deliver on titillating expectations based on relatively simple "atomizing" schemes focusing on one domain/level, while ignoring virtually all others. This multi-dimensional integrated approach is illustrated for the Alzheimer dementia-like syndrome taking advantage of the wealth of knowledge in several of the relevant domains, but is generally applicable to potentially the entire range of neurodegenerative disorders, and probably also to other aspects of normal and disordered cognition and behavior.

摘要

神经退行性疾病是一组异质性病症,缺乏一个令人满意的统一概念框架。人们普遍认为这种情况阻碍了我们充分理解这些疾病以开发有效治疗和预防方法的进程,但对于如何解决这一困境,并没有达成一致甚至普遍认可的解决方案。在此,我们提出,要解决这一难题,需要以综合的方式处理组织和(正常及紊乱的)功能的多个维度和尺度,这些维度和尺度包括但不限于传统的空间、时间、分子生物学/生物化学以及系统神经科学等层面。这种方法还必须包括对疾病分类概念的修订,目前的疾病分类概念试图将病理生理和病因解释强行纳入单一领域(目前主要是分子/生物化学领域),而基于相对简单的专注于一个领域/层面的“原子化”方案(几乎忽略了所有其他领域),这些概念几乎总是无法实现令人兴奋的预期。利用几个相关领域的丰富知识,我们以阿尔茨海默病样综合征为例说明了这种多维综合方法,但它通常适用于潜在的所有神经退行性疾病范围,甚至可能适用于正常和紊乱认知与行为的其他方面。

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