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一名患有抑郁症和焦虑症患者的阿尔茨海默病型神经病理变化:一例病例报告及阿尔茨海默病神经精神症状神经病理相关性的文献综述

Alzheimer's Type Neuropathological Changes in a Patient with Depression and Anxiety: A Case Report and Literature Review of Neuropathological Correlates of Neuropsychiatric Symptoms in Alzheimer's Disease.

作者信息

Das Sumit

机构信息

Department of Laboratory Medicine and Pathology (Neuropathology), University of Alberta Hospital, Edmonton, Alberta, Canada.

Neuroscience and Mental Health Institute, University of Alberta, Edmonton, Alberta, Canada.

出版信息

Case Rep Neurol Med. 2023 Oct 11;2023:5581288. doi: 10.1155/2023/5581288. eCollection 2023.

Abstract

Alzheimer's disease (AD) is classified as a tauopathy and is the most common neuropathological correlate of dementia/cognitive impairment. AD is neuropathologically characterized by the presence of beta-amyloid immunoreactive senile plaques and tau positive neurofibrillary tangles. Neuropsychiatric symptoms of AD however continue to be underscored, and therefore, neuropathological correlates of these neuropsychiatric symptoms are not readily studied. Presented here is a case of 60-year-old female who initially presented with anxiety and depression, and continued to be the predominant symptoms although mild cognitive impairment was noted as per the available clinical notes. Postmortem examination of the brain revealed severe Alzheimer's type neuropathological changes, which included significant tau and beta-amyloid pathology in limbic regions, which were thought to represent correlates of the patient's depression and anxiety. This case report illustrates the possible neuropathological correlates of neuropsychiatric symptoms in patients with AD. The author hopes that such a case will promote more in-depth studies into the pathophysiology of neuropsychiatric manifestations in AD.

摘要

阿尔茨海默病(AD)被归类为一种tau蛋白病,是痴呆/认知障碍最常见的神经病理学相关疾病。AD的神经病理学特征是存在β-淀粉样蛋白免疫反应性老年斑和tau蛋白阳性神经原纤维缠结。然而,AD的神经精神症状仍未得到充分重视,因此,这些神经精神症状的神经病理学相关因素尚未得到充分研究。本文报告了一例60岁女性病例,该患者最初表现为焦虑和抑郁,尽管根据现有临床记录发现有轻度认知障碍,但这些症状仍为主要症状。脑部尸检显示严重的阿尔茨海默病类型神经病理学改变,包括边缘区域显著的tau蛋白和β-淀粉样蛋白病变,这些病变被认为与患者的抑郁和焦虑相关。本病例报告说明了AD患者神经精神症状可能的神经病理学相关因素。作者希望这样一个病例将促进对AD神经精神表现病理生理学的更深入研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a63b/10584483/4b321b877370/CRINM2023-5581288.001.jpg

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