Lowe J
Dept Clinical Laboratory Sciences, University of Nottingham Medical School, UK.
Brain Pathol. 1998 Apr;8(2):403-6. doi: 10.1111/j.1750-3639.1998.tb00163.x.
While clinicopathological studies have confirmed that Alzheimer's disease (AD) is the most common neurodegenerative cause of dementia, these same studies have also revealed that other degenerative pathologies account for a significant proportion of patients with cognitive decline. Because pathological assessment of non-Alzheimer neurodegenerative diseases now demands routine use of a costly panel of immunohistochemical techniques a scheme for staged examination of brain tissue has been developed. This scheme is weighted to initially screen out cases of Alzheimer's disease, dementia with Lewy bodies and vascular dementia using conventional staining methods and established diagnostic protocols, bringing in immunochemical techniques to discriminate between non-Alzheimer degenerative dementias. Diagnosis of pathologies causing the clinical syndrome of frontotemporal dementia can be ascertained using conventional staining supplemented by immunochemical detection of ubiquitin, tau protein and alpha beta crystallin. The diagnosis of prion disease is reliably confirmed by immunohistochemical detection of prion protein. This morphological assessment complements emerging genetic insights into many of these neurodegenerative diseases.
虽然临床病理研究已证实阿尔茨海默病（AD）是痴呆最常见的神经退行性病因，但这些研究也表明，其他退行性病变在认知功能下降患者中占相当比例。由于现在对非阿尔茨海默神经退行性疾病进行病理评估需要常规使用一组昂贵的免疫组化技术，因此已制定了一种脑组织分期检查方案。该方案重点是先用传统染色方法和既定诊断方案初步筛查出阿尔茨海默病、路易体痴呆和血管性痴呆病例，再采用免疫化学技术区分非阿尔茨海默退行性痴呆。使用常规染色并辅以泛素、tau蛋白和αβ晶状体蛋白的免疫化学检测，可确定导致额颞叶痴呆临床综合征的病变诊断。通过免疫组化检测朊病毒蛋白可可靠地确诊朊病毒病。这种形态学评估补充了对许多这些神经退行性疾病新出现的遗传学认识。
