Hanihara T, Amano N, Takahashi T, Itoh Y, Yagishita S
Division of Psychiatry, Kanagawa Rehabilitation Center, Nanasawa, Atsugi, Japan.
Eur Neurol. 1998;39(2):97-102. doi: 10.1159/000007915.
Hypertrophic changes in the inferior olivary nuclei have been occasionally described in patients with progressive supranuclear palsy (PSP). To elucidate the incidence of olivary hypertrophy, we investigated morphologically the olives and their associated pathways in 20 autopsied cases: 11 cases of PSP, 3 cases of Machado-Joseph disease and 6 cases of dentatorubropallidoluysian atrophy (DRPLA) as control diseases that usually exhibited lesions of the cerebellofugal pathway. Olivary hypertrophy was observed in 5 of 11 PSP cases, but not in the other diseases, except for 1 case of DRPLA with an old infarct in the dentate nucleus. In the olivopetal pathway, grumose degeneration of the dentate nucleus and mild neuronal loss in the red nucleus were observed in all patients with PSP and in the control subjects. Atrophy and fibrillary gliosis of the tegmentum of the pons, including that of the bilateral central tegmental tracts, were observed in all patients with PSP, more severe in the cases with hypertrophic neurons in the olives. We speculate that a lesion that involves the central tegmental tracts may play a major role in inducing hypertrophy of the olives in patients with PSP.
在进行性核上性麻痹（PSP）患者中，偶尔会有关于下橄榄核肥大改变的描述。为了阐明橄榄核肥大的发生率，我们对20例尸检病例的橄榄核及其相关通路进行了形态学研究：11例PSP患者、3例马查多-约瑟夫病患者以及6例齿状核红核苍白球路易体萎缩症（DRPLA）患者作为对照疾病，这些对照疾病通常表现为小脑传出通路的病变。在11例PSP病例中有5例观察到橄榄核肥大，但在其他疾病中未观察到，除了1例齿状核有陈旧性梗死的DRPLA患者。在橄榄体传入通路中，所有PSP患者和对照受试者均观察到齿状核颗粒状变性以及红核轻度神经元丢失。所有PSP患者均观察到脑桥被盖萎缩和纤维性胶质增生，包括双侧中央被盖束，在橄榄核神经元肥大的病例中更为严重。我们推测，涉及中央被盖束的病变可能在PSP患者橄榄核肥大的诱导中起主要作用。
