Liu Alan King Lun, Chang Raymond Chuen-Chung, Pearce Ronald K B, Gentleman Steve M
Neuropathology Unit, Division of Brain Sciences, Department of Medicine, Imperial College London, London, UK,
Acta Neuropathol. 2015 Apr;129(4):527-40. doi: 10.1007/s00401-015-1392-5. Epub 2015 Jan 30.
It has been well established that neuronal loss within the cholinergic nucleus basalis of Meynert (nbM) correlates with cognitive decline in dementing disorders such as Alzheimer's disease (AD). Friedrich Lewy first observed his eponymous inclusion bodies in the nbM of postmortem brain tissue from patients with Parkinson's disease (PD) and cell loss in this area can be at least as extensive as that seen in AD. There has been confusion with regard to the terminology and exact localisation of the nbM within the human basal forebrain for decades due to the diffuse and broad structure of this "nucleus". Also, while topographical projections from the nbM have been mapped out in subhuman primates, no direct clinicopathological correlations between subregional nbM and cortical pathology and specific cognitive profile decline have been performed in human tissue. Here, we review the evolution of the term nbM and the importance of standardised nbM sampling for neuropathological studies. Extensive review of the literature suggests that there is a caudorostral pattern of neuronal loss within the nbM in AD brains. However, the findings in PD are less clear due to the limited number of studies performed. Given the differing neuropsychiatric and cognitive deficits in Lewy body-associated dementias (PD dementia and dementia with Lewy bodies) as compared to AD, we hypothesise that a different pattern of neuronal loss will be found in the nbM of Lewy body disease brains. Understanding the functional significance of the subregions of the nbM could prove important in elucidating the pathogenesis of dementia in PD.
业已明确，在诸如阿尔茨海默病（AD）等痴呆症中，Meynert基底核（nbM）内的神经元丢失与认知功能下降相关。Friedrich Lewy首次在帕金森病（PD）患者的死后脑组织的nbM中观察到以其名字命名的包涵体，并且该区域的细胞丢失至少与AD中所见的一样广泛。几十年来，由于这个“核”的结构弥散且广泛，关于nbM在人类基底前脑内的术语和确切定位一直存在混淆。此外，虽然在非人灵长类动物中已经绘制出了来自nbM的拓扑投射图，但在人体组织中尚未进行nbM亚区域与皮质病理及特定认知谱下降之间的直接临床病理相关性研究。在此，我们回顾了nbM这一术语的演变以及标准化nbM采样在神经病理学研究中的重要性。对文献的广泛回顾表明，AD脑内nbM中存在神经元丢失的尾-嘴侧模式。然而，由于所进行的研究数量有限，PD中的发现尚不清楚。鉴于与AD相比，路易体相关痴呆（PD痴呆和路易体痴呆）存在不同的神经精神和认知缺陷，我们推测在路易体病脑的nbM中会发现不同的神经元丢失模式。了解nbM亚区域的功能意义可能对阐明PD痴呆的发病机制具有重要意义。
