McKeel D W, Ball M J, Price J L, Smith D S, Miller J P, Berg L, Morris J C
Department of Pathology Neuropathology, Washington University School of Medicine, St. Louis, Missouri 63110.
Alzheimer Dis Assoc Disord. 1993 Fall;7(3):136-51. doi: 10.1097/00002093-199307030-00003.
Three investigators have applied different histopathologic methods (modified Bielschowsky silver methods, Congo red-gallocyanin) to differentiate Alzheimer's disease (AD) (n = 7 subjects; four with very mild dementia and three with moderate to advanced dementia) neuropathology from brain changes associated with aging in three nondemented individuals who had been evaluated using a validated dementia severity staging instrument [Washington University Clinical Dementia Rating (CDR)] generally within a year of death. The presence of elevated numbers of neocortical (frontal and temporal) diffuse, mature, and total senile plaques (SP) was strongly correlated with the presence of clinical AD but did not equate with CDR dementia severity. Neocortical neurofibrillary tangle (NFT) density as well as hippocampal NFT and SP density in this small series did not differentiate statistically between AD and controls. NFT density appeared to correlate with CDR better than SP density. Quantitative histopathologic assessment of AD markers in only a few brain regions can accurately predict the presence of clinical AD, including the very mild form of the disease. This is especially true for SP in the neocortex.
三名研究人员应用了不同的组织病理学方法（改良的 Bielschowsky 银染法、刚果红-焦宁），以区分阿尔茨海默病（AD）（n = 7 名受试者；4 名患有极轻度痴呆，3 名患有中度至重度痴呆）的神经病理学与三名非痴呆个体与衰老相关的脑变化。这三名非痴呆个体在死亡前一年内一般都使用经过验证的痴呆严重程度分期工具[华盛顿大学临床痴呆评定量表（CDR）]进行了评估。新皮质（额叶和颞叶）弥漫性、成熟和总老年斑（SP）数量的增加与临床 AD 的存在密切相关，但与 CDR 痴呆严重程度并不等同。在这个小样本系列中，新皮质神经原纤维缠结（NFT）密度以及海马 NFT 和 SP 密度在 AD 组和对照组之间没有统计学差异。NFT 密度似乎比 SP 密度与 CDR 的相关性更好。仅在少数脑区对 AD 标志物进行定量组织病理学评估就能准确预测临床 AD 的存在，包括疾病的极轻度形式。对于新皮质中的 SP 尤其如此。
