Del Tredici Kelly, Braak Heiko
Clinical Neuroanatomy Section, Department of Neurology, Center for Biomedical Research, University of Ulm, Ulm, Germany.
Curr Opin Neurol. 2022 Oct 1;35(5):660-671. doi: 10.1097/WCO.0000000000001098. Epub 2022 Aug 8.
Intracellular inclusions consisting of the abnormal TDP-43 protein and its nucleocytoplasmic mislocalization in selected cell types are hallmark pathological features of sALS. Descriptive (histological, morphological), anatomical, and molecular studies all have improved our understanding of the neuropathology of sporadic amyotrophic lateral sclerosis (sALS). This review highlights some of the latest developments in the field.
Increasing evidence exists from experimental models for the prion-like nature of abnormal TDP-43, including a strain-effect, and with the help of neuroimaging-based studies, for spreading of disease along corticofugal connectivities in sALS. Progress has also been made with respect to finding and establishing reliable biomarkers (neurofilament levels, diffusor tensor imaging).
The latest findings may help to elucidate the preclinical phase of sALS and to define possible mechanisms for delaying or halting disease development and progression.
由异常TDP-43蛋白组成的细胞内包涵体及其在特定细胞类型中的核质错误定位是散发性肌萎缩侧索硬化症(sALS)的标志性病理特征。描述性(组织学、形态学)、解剖学和分子研究均增进了我们对散发性肌萎缩侧索硬化症(sALS)神经病理学的理解。本综述重点介绍了该领域的一些最新进展。
实验模型提供了越来越多的证据,证明异常TDP-43具有朊病毒样特性,包括毒株效应,并且在基于神经影像学的研究帮助下,证明了疾病在sALS中沿皮质传出连接扩散。在寻找和建立可靠的生物标志物(神经丝水平、扩散张量成像)方面也取得了进展。
最新发现可能有助于阐明sALS的临床前期,并确定延缓或阻止疾病发展和进展的可能机制。