Samuel W, Terry R D, DeTeresa R, Butters N, Masliah E
Department of Neurosciences, University of California-San Diego.
Arch Neurol. 1994 Aug;51(8):772-8. doi: 10.1001/archneur.1994.00540200048015.
We correlated severity of dementia in Alzheimer's disease with the degree of neuropathology in cortical and subcortical brain regions.
In 13 patients with Alzheimer's disease who underwent neuropsychological testing before death, we assessed neurofibrillary tangles, senile plaques, and neuronal and synaptic density in the midfrontal cortex and the nucleus basalis of Meynert.
In the midfrontal cortex, synapse density was the strongest correlate of dementia severity, followed by neurofibrillary tangles. In the nucleus basalis, by contrast, neurofibrillary tangles were the strongest correlate, followed by synapse density. Stepwise regression analyses showed midfrontal synapse density to be the strongest predictor of tests emphasizing higher cortical functions, but neurofibrillary tangles in the nucleus basalis were the strongest predictor on memory-oriented tests.
The specificity of pathology in cortical vs subcortical locations for predicting a particular quality of neuropsychological deficit probably reflects disruption of corticocortical connections vs derangement of the basal forebrain cholinergic system.
我们将阿尔茨海默病中痴呆的严重程度与皮质和皮质下脑区的神经病理学程度进行关联。
在13例生前接受过神经心理学测试的阿尔茨海默病患者中，我们评估了额中回皮质和Meynert基底核中的神经原纤维缠结、老年斑以及神经元和突触密度。
在额中回皮质，突触密度与痴呆严重程度的相关性最强，其次是神经原纤维缠结。相比之下，在Meynert基底核中，神经原纤维缠结的相关性最强，其次是突触密度。逐步回归分析表明，额中回突触密度是强调高级皮质功能测试的最强预测因子，但Meynert基底核中的神经原纤维缠结是记忆导向测试的最强预测因子。
皮质与皮质下部位病理对于预测特定神经心理学缺陷性质的特异性，可能反映了皮质-皮质连接的破坏与基底前脑胆碱能系统的紊乱。
