Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA,
Curr Neurol Neurosci Rep. 2013 Dec;13(12):412. doi: 10.1007/s11910-013-0412-x.
Alzheimer's disease (AD) is thought to progress in a fairly stereotyped manner, with episodic memory loss being the first and most salient domain of impairment, reflecting the early disease in structures supporting this function. However, there is considerable heterogeneity in the relative involvement of different cognitive domains, and at the extreme are three syndromes associated with AD: (1) logopenic progressive aphasia, (2) posterior cortical atrophy, and (3) frontal variant of AD. As each of these syndromes is variably associated with non-AD dementia and clinically overlaps with other presentations more commonly associated with different causes of neurodegeneration (e.g., progressive nonfluent aphasia), the use of amyloid imaging for detection of the molecular pathologic features of AD is of significant clinical value. This article reviews several amyloid imaging studies of these populations which support autopsy case series and reveal a dissociation between the spatial distribution of amyloid plaques and clinical phenotype.
阿尔茨海默病(AD)被认为是以相当刻板的方式进展的,以情景记忆丧失为首发和最突出的损害领域,反映了支持这一功能的结构的早期疾病。然而,不同认知领域的相对参与存在很大的异质性,在极端情况下,有三种与 AD 相关的综合征:(1)失语法性进行性失语症,(2)后皮质萎缩,(3)AD 的额变异型。由于这些综合征中的每一种都与非 AD 痴呆症不同程度地相关,并且在临床上与其他更常见的与不同神经退行性病因相关的表现重叠(例如,进行性非流利性失语症),因此使用淀粉样蛋白成像来检测 AD 的分子病理特征具有重要的临床价值。本文综述了几项针对这些人群的淀粉样蛋白成像研究,这些研究支持尸检病例系列,并揭示了淀粉样蛋白斑块的空间分布与临床表型之间的分离。