Alzheimer病患者疾病感缺失与海马右尖下托淀粉样斑块密度有关  

Right prosubiculum amyloid plaque density correlates with anosognosia in Alzheimer’s disease

作　　者：Marshall G.A. Kaufer D.I. Lopez O.L. 李锐 

机构地区：[1]UNC School of Medicine, CB#7025, 3114 Bioinformatics Bldg., Chapel Hill, NC 27599, United States Dr.

出　　处：《世界核心医学期刊文摘（神经病学分册）》2005年第2期31-32,共2页Digest of the World Core Medical Journals:Clinical Neurology

摘　　要：Background: Anosognosia is a common manifestation of Al zheimers disease. T here is an association between impaired awareness and frontal executive cogniti ve deficits. Anosognosia is also correlated with decreased metabolism in the rig ht hemisphere, particularly in frontal lobe regions. Objective: To investigate p athological correlates of anosognosia in Alzhe imers disease. Design: 41 subj ects followed longitudinally in the University of Pittsburgh memory disorders cl inic and with necropsy verified Alzheimers disease were divided into two group s, based on previous clinical assessment: +Aware (n = 23) and Aware (n = 18). A subset analysis matching sub jects for dementia severity using mini mental state examination scores was also carried out (13 +Aware; 13 Aware). Histopat hological data from necropsy brain tissue consisted of senile plaque (SP) and ne urofibrillary tangle (NFT) counts (regional density) from four different brain r egions in the right and left hemispheres: superior and middle frontal gyri (SMF) , superior temporal isocortex (ST), the prosubiculum of the hippocampus (PRO), a nd the entorhinal cortex (EC). Results: SP density was greater in the right PRO region of Aware subjects (F = 6.54, p = 0.015) than +Aware subjects. Signific ant differences between SP or NFT density were not observed in any other regions . In the subset analysis matching for dementia severity, SP density was again gr eater in the right PRO region of Aware subjects than in the other regions (F = 12.72, p = 0.002). Conclusions: Increased SP density in the right PRO region suggests that selective pathological involvement of th is area contributes to awareness deficits in Alzheimers disease. The putative role of the PRO in self appraisal may reflect its interconnections with other me dial temporal and prefrontal regions.Background: Anosognosia is a common manifestation of Al zheimers disease. T here is an association between impaired awareness and frontal executive cogniti ve deficits. Anosognosia is also correlated with decreased metabolism in the rig ht hemisphere, particularly in frontal lobe regions. Objective: To investigate p athological correlates of anosognosia in Alzhe imers disease. Design: 41 subj ects followed longitudinally in the University of Pittsburgh memory disorders cl inic and with necropsy verified Alzheimers disease were divided into two group s, based on previous clinical assessment: +Aware (n = 23) and Aware (n = 18). A subset analysis matching sub jects for dementia severity using mini mental state examination scores was also carried out (13 +Aware; 13 Aware). Histopat hological data from necropsy brain tissue consisted of senile plaque (SP) and ne urofibrillary tangle (NFT) counts (regional density) from four different brain r egions in the right and left hemispheres: superior and middle frontal gyri (SMF) , superior temporal isocortex (ST), the prosubiculum of the hippocampus (PRO), a nd the entorhinal cortex (EC). Results: SP density was greater in the right PRO region of Aware subjects (F = 6.54, p = 0.015) than +Aware subjects. Signific ant differences between SP or NFT density were not observed in any other regions . In the subset analysis matching for dementia severity, SP density was again gr eater in the right PRO region of Aware subjects than in the other regions (F = 12.72, p = 0.002). Conclusions: Increased SP density in the right PRO region suggests that selective pathological involvement of th is area contributes to awareness deficits in Alzheimers disease. The putative role of the PRO in self appraisal may reflect its interconnections with other me dial temporal and prefrontal regions.

关 键 词：淀粉样 ALZHEIMER病 下托 斑块密度 神经纤维缠结 病理学变化 右侧大脑半球 认知障碍 内嗅皮质 颞上回 

分 类 号：R749.16[医药卫生—神经病学与精神病学]