Hansen L A, Masliah E, Galasko D, Terry R D
Department of Neurosciences, University of California, San Diego, La Jolla 92093-0624.
J Neuropathol Exp Neurol. 1993 Nov;52(6):648-54. doi: 10.1097/00005072-199311000-00012.
A minority of neuropathologically confirmed Alzheimer disease (AD) brains lack neocortical neurofibrillary tangles or have very few, constituting a form of "plaque-only AD." A significant percentage of clinically diagnosed AD patients are found at autopsy to have both AD and brainstem and neocortical Lewy bodies. Many of these Lewy body variants of AD (LBV) have numerous senile plaques but no neocortical neurofibrillary tangles, and so resemble plaque-only AD. In this study, we sought to determine if plaque-only AD was usually LBV, and, conversely, if LBV was usually plaque-only AD. We analyzed 147 consecutively accessioned cases of neuropathologically confirmed AD, diagnosed according to criteria from the National Institute on Aging and the Consortium to Establish a Registry for Alzheimer's Disease. Twenty-five percent of all AD cases in this series were plaque-only AD, and 75% were plaque and tangle AD. Twenty-eight percent of AD cases in this series were LBV, and 72% were pure AD. Of the plaque-only AD cases, 75% were LBV and only 25% were pure AD. Of the LBV, 66% were plaque-only AD and only 33% were plaque and tangle AD. These results indicate that most plaque-only AD is LBV, and, conversely, that most LBV is plaque-only AD.
少数经神经病理学确诊的阿尔茨海默病（AD）患者大脑缺乏新皮质神经原纤维缠结或仅有极少的神经原纤维缠结，构成一种“仅存在斑块的AD”形式。相当比例临床诊断为AD的患者尸检时发现同时患有AD以及脑干和新皮质路易体。许多这些AD的路易体变异型（LBV）有大量老年斑但无新皮质神经原纤维缠结，因此类似于仅存在斑块的AD。在本研究中，我们试图确定仅存在斑块的AD是否通常为LBV，反之，LBV是否通常为仅存在斑块的AD。我们分析了147例连续登记的经神经病理学确诊的AD病例，这些病例根据美国国立衰老研究所和阿尔茨海默病注册协会的标准进行诊断。该系列中所有AD病例的25%为仅存在斑块的AD，75%为既有斑块又有缠结的AD。该系列中28%的AD病例为LBV，72%为单纯AD。在仅存在斑块的AD病例中，75%为LBV，仅25%为单纯AD。在LBV中，66%为仅存在斑块的AD，仅33%为既有斑块又有缠结的AD。这些结果表明，大多数仅存在斑块的AD是LBV，反之，大多数LBV是仅存在斑块的AD。
