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[特纳综合征的神经病理学]

[Neuropathology of the Turner syndrome].

作者信息

Della Giustina E, Forabosco A, Botticelli A R, Pace P

出版信息

Pediatr Med Chir. 1985 Jan-Feb;7(1):49-55.

PMID:4088914
Abstract

We report the neuropathologic examination of a neonatal case of Turner's syndrome (45,XO). We have found some mild irregularities in the cortical organization, notably in frontal and hippocampal regions. In the frontal cortex such anomalies affected particularly the more superficial layers essentially sparing the migrating process which was largely achieved in its fundamental phases. The hippocampal dentate gyrus appeared abnormally infolded. The cerebellum was hypoplasic and contained three types of abnormalities, at least: abundant paradentate matrix cell nests, a large mass of dysplastic cerebellar gyri along the ventral wall of the 4th ventricle and, finally, multiple voluminous heterotopias of macroneurons (possibly, Purkinje cells) in the subcortical white matter. In addition, there were two small olivary heterotopias in the medulla oblongata. The correct identification of all neuropathologic anomalies has been possible for having employed the method of whole brain serial sectioning. We have correlated such cortical, cerebellar and truncal abnormalities to those encountered in similar conditions as lissencephaly, Zellweger's disease and chromosomal trisomies. The pathogenetic mechanisms triggered by the absence of an X chromosome can affect the neuronal migration, but only after the cortical hemispheric one has been almost completely ended. This could explain why cerebellar and olivary neuronal migration are exclusively affected, being there the migration process chronologically slowed down during the normal neurogenesis. There means we might date after the 4th fetal months the neuronal migration trouble. Finally, we would suggest the soft cortical changes in such crucial regions as the frontal and hippocampal cortex to be possibly responsible for the degree of mental retardation seen in these patients.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

我们报告了一例特纳综合征(45,XO)新生儿的神经病理学检查结果。我们发现其皮质组织存在一些轻度异常,尤其是在额叶和海马区。在额叶皮质,此类异常特别影响较浅的层,基本未累及迁移过程,而迁移过程在其基本阶段已大体完成。海马齿状回出现异常折叠。小脑发育不全,至少包含三种异常:大量齿状核旁基质细胞巢、沿第四脑室腹侧壁的一大团发育异常的小脑回,以及最后在皮质下白质中多个大量的大神经元(可能是浦肯野细胞)异位。此外,延髓中有两个小的橄榄核异位。由于采用了全脑连续切片法,得以正确识别所有神经病理学异常。我们将此类皮质、小脑和脑干异常与无脑回畸形、泽尔韦格病和染色体三体等类似病症中所遇到的异常进行了关联。X染色体缺失引发的致病机制可影响神经元迁移,但仅在皮质半球迁移几乎完全结束之后。这可以解释为何仅小脑和橄榄核神经元迁移受到影响,因为在正常神经发生过程中,那里的迁移过程在时间上有所减缓。这意味着我们或许可以将神经元迁移问题追溯到胎儿第4个月之后。最后,我们认为额叶和海马皮质等关键区域的轻度皮质变化可能是这些患者智力发育迟缓程度的原因。(摘要截选于250词)

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