Whitehouse P J, Struble R G, Hedreen J C, Clark A W, Price D L
CRC Crit Rev Clin Neurobiol. 1985;1(4):319-39.
The brains of individuals with dementia due to Alzheimer's disease (AD), Parkinson's disease (PD), and Down's syndrome (DS) exhibit similar neuropathological features, including neuritic plaques, neurofibrillary tangles, and the loss of specific populations of neurons. In addition, these brains show similar transmitter-specific neurochemical alterations. Recent evidence indicates that several pathological and neurochemical changes are related to diseases involving projection systems innervating the telencephalon. At least two transmitter-specific circuits, cholinergic neurons in the basal forebrain and noradrenergic neurons in the locus coeruleus, are selectively affected in many patients with these disorders. This review focuses on these systems because they provide particularly useful examples of the ways in which multidisciplinary studies can provide new clinical-pathological-chemical correlations. Strategies used in these studies are applicable to a wide variety of other neurodegenerative diseases affecting specific populations of neurons. Modern neuropathological approaches to these diseases should eventually allow investigators to directly relate pathogenic processes involving transmitter-specific neuronal populations, whose projections, physiological properties, and functions are known, with the clinical manifestations occurring in human disorders of behavior and cognition.
患有阿尔茨海默病（AD）、帕金森病（PD）和唐氏综合征（DS）所致痴呆症的个体大脑呈现出相似的神经病理学特征，包括神经炎性斑块、神经原纤维缠结以及特定神经元群体的丧失。此外，这些大脑还表现出相似的递质特异性神经化学改变。最近的证据表明，一些病理和神经化学变化与涉及支配端脑的投射系统的疾病有关。在许多患有这些疾病的患者中，至少有两个递质特异性回路，即基底前脑的胆碱能神经元和蓝斑中的去甲肾上腺素能神经元，受到选择性影响。本综述聚焦于这些系统，因为它们为多学科研究如何提供新的临床-病理-化学相关性提供了特别有用的例子。这些研究中使用的策略适用于影响特定神经元群体的多种其他神经退行性疾病。针对这些疾病的现代神经病理学方法最终应能使研究人员直接将涉及递质特异性神经元群体的致病过程（其投射、生理特性和功能已知）与人类行为和认知障碍中出现的临床表现联系起来。
