Leuba G, Saini K
University Psychogeriatrics Hospital, Lausanne, Switzerland.
Neuropathol Appl Neurobiol. 1995 Oct;21(5):410-22. doi: 10.1111/j.1365-2990.1995.tb01078.x.
Subcortical visual centres such as the lateral geniculate nucleus, the lateral inferior pulvinar and the superior colliculus, together with the primary visual cortex and its adjacent white matter, were studied in 12 Alzheimer brains and five age-matched controls. The periodic acid methenamine technique was used for the demonstration of senile plaques and the Gallyas technique for neurofibrillary tangles and neuritic threads in the neuropil. In the lateral geniculate nucleus and inferior pulvinar, the presence of periodic acid methenamine-positive senile plaques was observed in variable numbers in all Alzheimer cases. In the lateral geniculate nucleus, senile plaques were encountered more often in parvocellular than in magnocellular layers, in the interlaminar zones, in the optic radiation and in the adjacent pre-geniculate nucleus. Gallyas staining did not reveal any neurofibrillary tangles, neuritic threads or neuritic plaques, meaning that in this thalamic region there are mainly amyloid deposits without neuritic degeneration. In the superior colliculus both amyloid and neuritic plaques, as well as neurofibrillary tangles and neuritic threads were encountered in the superficial and deep layers. In the primary visual cortex, all types of senile plaques were observed as well as a rather high number of neurofibrillary lesions in pyramidal neurons, mainly in layers 5 and 6, but also in several types of non-pyramidal neurons. In the underlying white matter there was a morphologically heterogeneous population of neurofibrillary tangle-bearing neurons and a considerable number of threads representing degenerating axons, suggesting that degeneration could follow corticosubcortical connections. These data demonstrate that lesions in the primary visual structures and pathways are more prevalent than previously observed and could partly explain the visual disturbances in Alzheimer's disease.
对12例阿尔茨海默病患者的大脑和5例年龄匹配的对照者，研究了外侧膝状体、外侧下枕叶和上丘等皮质下视觉中枢，以及初级视觉皮质及其相邻的白质。采用高碘酸甲苯胺蓝技术显示老年斑，采用加利亚斯技术显示神经原纤维缠结和神经毡中的神经突丝。在外侧膝状体和下枕叶，所有阿尔茨海默病病例中均可见数量不等的高碘酸甲苯胺蓝阳性老年斑。在外侧膝状体中，小细胞层比大细胞层、层间区、视辐射和相邻的膝状体前核中更常出现老年斑。加利亚斯染色未发现任何神经原纤维缠结、神经突丝或神经炎性斑块，这意味着在该丘脑区域主要是淀粉样蛋白沉积，没有神经炎性变性。在上丘的浅层和深层均发现了淀粉样蛋白和神经炎性斑块，以及神经原纤维缠结和神经突丝。在初级视觉皮质中，观察到了所有类型的老年斑，以及锥体细胞中相当数量的神经原纤维病变，主要在第5层和第6层，但在几种非锥体细胞中也有。在其下方的白质中，存在形态学上异质性的带有神经原纤维缠结的神经元群体，以及相当数量代表轴突退变的细丝，提示退变可能沿着皮质-皮质下连接发生。这些数据表明，初级视觉结构和通路中的病变比以前观察到的更为普遍，这可能部分解释了阿尔茨海默病中的视觉障碍。
