Esiri M M, Pearson R C, Steele J E, Bowen D M, Powell T P
Department of Neuropathology, Radcliffe Infirmary, Oxford, United Kingdom.
J Neurol Neurosurg Psychiatry. 1990 Feb;53(2):161-5. doi: 10.1136/jnnp.53.2.161.
A quantitative study has been made of the number of neurofibrillary tangles and of the choline acetyltransferase activity in several sites in the cerebral hemispheres of eight patients who had had Alzheimer's disease. The neurofibrillary tangles were maximal in structures in the medial temporal lobe (uncus, amygdala, hippocampus and parahippocampal gyrus), severe in the neocortex on the lateral surface of the temporal lobe, moderate in the "association cortex" of the parietal and frontal lobes and minimal in primary somatic and visual sensory areas. There was a significant decrease in choline acetyltransferase activity in almost all areas, and the means of the percentage decreases for the different groups of areas correlate well with the counts of the neurofibrillary tangles. These results support the hypothesis that the pathological process in Alzheimer's disease may spread along a sequence of corticocortical connections between the main sensory areas and the hippocampal formation. The disease process may also spread along the reciprocal connections between the amygdala and the neocortex because the numbers of tangles in different areas of the neocortex closely parallel the density of their connections and the amygdala.
对8例阿尔茨海默病患者大脑半球若干部位的神经原纤维缠结数量和胆碱乙酰转移酶活性进行了定量研究。神经原纤维缠结在内侧颞叶结构（钩回、杏仁核、海马和海马旁回）中最多，在颞叶外侧面的新皮质中严重，在顶叶和额叶的“联合皮质”中中等，在主要躯体和视觉感觉区中最少。几乎所有区域的胆碱乙酰转移酶活性均显著降低，不同区域组的降低百分比均值与神经原纤维缠结计数密切相关。这些结果支持了这样一种假说，即阿尔茨海默病的病理过程可能沿着主要感觉区与海马结构之间的一系列皮质-皮质连接扩散。疾病过程也可能沿着杏仁核与新皮质之间的相互连接扩散，因为新皮质不同区域的缠结数量与它们和杏仁核的连接密度密切平行。
