Duyckaerts C, Hauw J J
Laboratoire de Neuropathologie R. Escourolle, Hôpital de La Salpêtrière, Paris, France.
Neurobiol Aging. 1997 Jul-Aug;18(4 Suppl):S33-42. doi: 10.1016/s0197-4580(97)00067-5.
Rather than determining lesions "threshold" between "normal" cases and patients, we prefer to use clinicopathological correlations, assigning a given intellectual deficit to a given amount of lesions with a chosen level of probability. Because large amounts of A beta diffuse deposits may be found in the absence of dementia, we think advisable not to take them into account for the diagnosis. The diffusion of the neurofibrillary tangles in the paralimbic, limbic and isocortical areas (described by braak and Braak stages or by the number of areas containing tangles) and the density of isocortical senile plaques (A beta focal deposits) as assessed by the CERAD protocol are both correlated with the intellectual status but give complementary information. They should thus be jointly used. We analyzed the variability of the lesions counts, their coefficients of error, and their causes, as a first step toward standardization. We have shown, however, that semiquantitative estimates are presently more reproducible than quantitative measures.
我们更倾向于使用临床病理相关性，而不是确定“正常”病例与患者之间病变的“阈值”，即将特定的智力缺陷与特定数量的病变以选定的概率水平相关联。由于在没有痴呆的情况下可能会发现大量β淀粉样蛋白弥漫性沉积，我们认为在诊断时不考虑它们是明智的。神经原纤维缠结在边缘旁、边缘和等皮质区域的扩散（由Braak和Braak分期或含有缠结的区域数量描述）以及通过CERAD方案评估的等皮质老年斑（β淀粉样蛋白局灶性沉积）密度均与智力状态相关，但提供互补信息。因此，它们应联合使用。作为标准化的第一步，我们分析了病变计数的变异性、其误差系数及其原因。然而，我们已经表明，目前半定量估计比定量测量更具可重复性。
