Braak H, Braak E
Department of Anatomy, J.W. Goethe University of Frankfurt, Frankfurt/Main, Federal Republic of Germany.
Neuropathol Appl Neurobiol. 1989 Jan-Feb;15(1):13-26. doi: 10.1111/j.1365-2990.1989.tb01146.x.
Unusual cytoskeleton abnormalities were found in the brains of 28 individuals afflicted with adult onset dementia. Most conspicuous were small spindle-shaped argyrophilic grains loosely scattered throughout the neuropil. Additionally, coiled bodies of silver-stained filaments were encountered, mainly located within the white matter close to the cortical grey matter. Argyrophilic grains and coiled bodies contained dense accumulations of straight filaments with a diameter of about 9 nm. The argyrophilic grains were found in abundance within sector CA1 of the Ammon's horn and layer Pre-beta of the entorhinal region. A slightly less dense scattering of the grains occurred in layer IIIab of the adjoining temporal isocortex, insular cortex and orbitofrontal cortex. The basolateral amygdaloid complex and the hypothalamic lateral tuberal nucleus were the most affected subcortical structures. Deeper brain stem nuclei merely showed a sparse number of grains or were devoid of them. Eighty brains of demented individuals were examined. Forty-eight of them showed the features of Alzheimer's disease and four showed the features of Pick's disease. Twenty-eight cases revealed the abnormalities under consideration. Ten showed exclusively argyrophilic grains and coiled bodies, while 16 also had neuritic plaques, neurofibrillary tangles, and neuropil threads. One of the 28 cases was associated with Parkinson's disease and one showed features of both Parkinson's and Alzheimer's disease. Twenty brains of non-demented individuals of about the same age and devoid or almost devoid of Alzheimer changes were used as controls. None of the control brains showed the presence of argyrophilic grains and coiled bodies. These changes, therefore, are considered the morphological substrate of an unknown disease associated with adult onset dementia.
在28名成年期发病的痴呆症患者大脑中发现了异常的细胞骨架异常。最明显的是小的纺锤形嗜银颗粒,松散地散布在整个神经毡中。此外,还发现了银染细丝的卷曲体,主要位于靠近皮质灰质的白质内。嗜银颗粒和卷曲体含有直径约9纳米的直细丝密集堆积。在海马角的CA1区和内嗅区的β前层中大量发现嗜银颗粒。在相邻颞叶等皮质、岛叶皮质和眶额皮质的IIIab层中,颗粒的散布密度略低。基底外侧杏仁核复合体和下丘脑外侧结节核是受影响最严重的皮质下结构。更深层的脑干核仅显示少量颗粒或没有颗粒。对80名痴呆患者的大脑进行了检查。其中48例表现出阿尔茨海默病的特征,4例表现出皮克病的特征。28例显示出所考虑的异常。10例仅显示嗜银颗粒和卷曲体,而16例还具有神经炎性斑块、神经原纤维缠结和神经毡细丝。28例中有1例与帕金森病相关,1例表现出帕金森病和阿尔茨海默病的特征。将20名年龄相仿、无或几乎无阿尔茨海默病改变的非痴呆个体的大脑用作对照。对照大脑中均未显示嗜银颗粒和卷曲体的存在。因此,这些变化被认为是与成年期发病痴呆相关的一种未知疾病的形态学基础。