Bowen D M, Benton J S, Spillane J A, Smith C C, Allen S J
J Neurol Sci. 1982 Dec;57(2-3):191-202. doi: 10.1016/0022-510x(82)90026-0.
Cortical biopsies were taken from the frontal lobe of 25 patients with presenile dementia. Choline acetyltransferase (ChAT) activity, and in some specimens the high affinity uptake of choline, was used to estimate loss of cholinergic nerve terminals. Of the 15 samples with varying degrees of histological evidence of Alzheimer's disease (AD) 14 were from clinically suspected examples of the disease. There was significant loss of ChAT in 10 of the 15 compared with control and the mean activity was also highly significantly reduced (to 41% of control). The deficit was found in patients examined within a year of onset of symptoms. In 6 biopsies from clinically suspected cases of AD without diagnostic histological features there was loss of activity in only one, subsequently shown to have Jakob-Creutzfeldt disease. The remaining samples were two of vascular dementia (no loss of ChAT), one probable disorder of white matter (no loss of activity) and one undiagnosed disorder (with loss of ChAT activity). Thus most patients without histologically demonstrated AD had no evidence of a presynaptic cholinergic defect. It was concluded that suspected cases of AD particularly suitable for putative cholinergic therapy were those with an onset of the disease at 55 to 65 and an absence of family history.
对25例早老性痴呆患者的额叶进行了皮质活检。采用胆碱乙酰转移酶（ChAT）活性，以及部分标本中胆碱的高亲和力摄取，来评估胆碱能神经末梢的丧失情况。在15例具有不同程度阿尔茨海默病（AD）组织学证据的样本中，14例来自临床疑似该病的病例。与对照组相比，15例中有10例ChAT显著丧失，且平均活性也大幅降低（降至对照组的41%）。在症状出现一年内接受检查的患者中发现了这种缺陷。在6例临床疑似AD但无诊断性组织学特征的活检中，只有1例活性丧失，随后被诊断为克雅氏病。其余样本包括2例血管性痴呆（ChAT无丧失）、1例可能的白质疾病（活性无丧失）和1例未确诊疾病（ChAT活性丧失）。因此，大多数无组织学证实AD的患者没有突触前胆碱能缺陷的证据。得出的结论是，疑似AD病例中特别适合进行假定胆碱能治疗的是那些发病年龄在55至65岁且无家族史的患者。
