Cerebral cortex pathology in aging and Alzheimer's disease: a quantitative survey of large hospital-based geriatric and psychiatric cohorts

被引:145
作者
Giannakopoulos, P
Hof, PR
Michel, JP
Guimon, J
Bouras, C
机构
[1] UNIV GENEVA, SCH MED, DEPT GERIATR, HUG BELLE IDEE, CH-1225 GENEVA, SWITZERLAND
[2] MT SINAI SCH MED, NEUROBIOL AGING LABS, NEW YORK, NY 10029 USA
[3] MT SINAI SCH MED, FISHBERG RES CTR NEUROBIOL, NEW YORK, NY 10029 USA
[4] CUNY MT SINAI SCH MED, DEPT GERIATR & ADULT DEV, NEW YORK, NY 10029 USA
[5] CUNY MT SINAI SCH MED, DEPT GERIATR & ADULT DEV, NEW YORK, NY 10029 USA
[6] CUNY MT SINAI SCH MED, DEPT OPHTHALMOL, NEW YORK, NY 10029 USA
基金
美国国家卫生研究院;
关键词
Alzheimer's disease; amyloid; brain aging; centenarian; clinicopathologic correlation; hippocampus; neocortex; neurofibrillary tangle;
D O I
10.1016/S0165-0173(97)00023-4
中图分类号
Q189 [神经科学];
学科分类号
071006 ;
摘要
In order to explore the relationships between the involvement of specific neuronal populations and cognitive deterioration, and to compare the hierarchical patterns of cortical involvement in normal brain aging and Alzheimer's disease, over 1200 brains from elderly subjects without cognitive deficits, as well as from patients with age-associated memory impairment and Alzheimer's disease, were examined. Our results suggest that the neuropathological changes associated with normal brain aging and Alzheimer's disease affect select cortical circuits at different points in time. Extensive hippocampal alterations are correlated with age-associated memory impairment, whereas substantial neurofibrillary tangle formation in neocortical association areas of the temporal lobe is a prerequisite for the development of Alzheimer's disease. Despite several lines of evidence involving amyloid deposit in the pathogenesis of Alzheimer's disease and Down's syndrome, our observations indicate that there is no correlation between senile plaque densities and degree of dementia in both disorders. In contrast to younger elderly cases, in the ninth and tenth decades of life, there is a differential cortical involvement in that parietal and cingulate areas are early affected in the course of Alzheimer's disease, and neocortical senile plaques densities are strongly correlated with the severity of dementia. Moreover, Alzheimer's disease symptomatology is characterized in these very old patients by high neurofibrillary tangle densities in the anterior CA1 field, but not in the entorhinal cortex and inferior temporal cortex. These observations are discussed in the light of the hypothesis of global corticocortical disconnection and with respect to the notion of selective neuronal vulnerability in Alzheimer's disease. (C) 1997 Elsevier Science B.V.
引用
收藏
页码:217 / 245
页数:29
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