Jellinger K
Ludwig Boltzmann Institute of Clinical Neurobiology, Lainz Hospital, Vienna, Austria.
J Neural Transm Suppl. 1987;24:109-29.
The pathology of Alzheimer's disease (AD) and Parkinson's disease (PD) is characterized by degeneration of certain vulnerable neuronal populations that display several types of cytoskeletal abnormalities (Alzheimer-type lesions and Lewy bodies, respectively). These may serve as diagnostic markers, although they can be found in both types of disorders and, less frequently, in brains of normal aged individuals. AD pathology shows a preponderance for hippocampal, neocortical, and forebrain cholinergic systems; the hallmark of PD is damage to the nigrostriatal dopaminergic system. Both disorders show frequent involvement of subcortical projection systems that can be similar in quality and distribution, with similar multiple neuromediator dysfunction. The results of morphometric studies of some subcortical nuclei in AD and PD are reported and related with neurochemical data. In addition to classical forms of AD and PD, both types of lesions can coexist suggesting an increased risk of PD in patients with AD and vice versa. The basis for an association between the two disorders is unknown. Many AD cases with signs of PD have additional PD pathology, while cortical Alzheimer lesions may be seen in demented PD patients. However, dementia in PD does not imply coexistent cortical AD pathology; prominent subcortical lesions alone, or in combination with cortical AD pathology, may occur. AD and PD may show some differences in the primary locus of degenerative changes in specific cortical and subcortical neuronal systems, but the causative factors, mutual relations, and relative contributions to the clinical syndromes remain to be elucidated.
阿尔茨海默病（AD）和帕金森病（PD）的病理学特征是某些易损神经元群体发生退化，分别表现出几种类型的细胞骨架异常（分别为阿尔茨海默型病变和路易小体）。这些异常可作为诊断标志物，尽管它们在这两种疾病中均可发现，且在正常老年人的大脑中较少见。AD病理学表现为海马、新皮质和前脑胆碱能系统受累为主；PD的标志是黑质纹状体多巴胺能系统受损。这两种疾病均常累及皮质下投射系统，其性质和分布可能相似，伴有相似的多种神经介质功能障碍。本文报告了AD和PD中一些皮质下核的形态学研究结果，并将其与神经化学数据相关联。除了AD和PD的经典形式外，这两种病变可能并存，提示AD患者患PD的风险增加，反之亦然。这两种疾病之间关联的基础尚不清楚。许多有PD体征的AD病例存在额外的PD病理学改变，而痴呆的PD患者可能出现皮质阿尔茨海默病变。然而，PD中的痴呆并不意味着并存皮质AD病理学改变；单独的显著皮质下病变或与皮质AD病理学改变并存的情况都可能发生。AD和PD在特定皮质和皮质下神经元系统退化变化的主要部位可能存在一些差异，但致病因素、相互关系以及对临床综合征的相对贡献仍有待阐明。
