Neary D, Snowden J S, Mann D M, Bowen D M, Sims N R, Northen B, Yates P O, Davison A N
J Neurol Neurosurg Psychiatry. 1986 Mar;49(3):229-37. doi: 10.1136/jnnp.49.3.229.
In a study of 17 patients with histologically proven Alzheimer's disease the relationship between psychological, pathological and chemical measures of disorder was examined. Severity of dementia, determined by mental test performance, correlated highly with pathological change in large cortical neurons (cell loss and reduction in nuclear and nucleolar volume and cytoplasmic RNA content), to a lesser extent with cortical senile plaque and neurofibrillary tangle frequency and reduction in acetylcholine (ACh) synthesis, and not with reduction in choline acetyltransferase (CAT) activity. A strongly significant relationship was demonstrated between cell loss and reductions in nuclear and nucleolar volume and cytoplasmic RNA content. Reduction in CAT activity and senile plaque frequency were significantly correlated, thereby linking changes in the sub-cortical projection system of the nucleus basalis with the cortical pathology. The pattern of correlations suggests that the dementia of Alzheimer's disease is largely a reflection of the state of large cortical neurons, and it is argued that abnormalities in the latter may not be directly related to primary loss of cholinergic neurons in the subcortex.
在一项针对17例经组织学证实患有阿尔茨海默病的患者的研究中，研究了疾病的心理、病理和化学指标之间的关系。通过心理测试表现确定的痴呆严重程度与大脑皮质大神经元的病理变化（细胞丢失、细胞核和核仁体积减小以及细胞质RNA含量降低）高度相关，与皮质老年斑和神经原纤维缠结频率以及乙酰胆碱（ACh）合成减少的相关性较小，与胆碱乙酰转移酶（CAT）活性降低无关。细胞丢失与细胞核和核仁体积减小以及细胞质RNA含量降低之间存在高度显著的关系。CAT活性降低与老年斑频率显著相关，从而将基底核的皮质下投射系统的变化与皮质病理联系起来。这种相关模式表明，阿尔茨海默病性痴呆在很大程度上反映了大脑皮质大神经元的状态，并且有人认为后者的异常可能与皮质下胆碱能神经元的原发性丢失没有直接关系。
