Olfactory bulb α-synucleinopathy has high specificity and sensitivity for Lewy body disorders

被引：466

作者：

Beach, Thomas G. ^{[1
]}

White, Charles L., III ^{[2
]}

Hladik, Christa L. ^{[2
]}

Sabbagh, Marwan N. ^{[1
]}

Connor, Donald J. ^{[1
]}

Shill, Holly A. ^{[1
]}

Sue, Lucia I. ^{[1
]}

Sasse, Jeanne ^{[1
]}

Bachalakuri, Jyothi ^{[1
]}

Henry-Watson, Jonette ^{[1
]}

Akiyama, Haru ^{[3
]}

Adler, Charles H. ^{[4
]}

机构：

[1] Sun Hlth Res Inst, Sun City, AZ 85351 USA

[2] Univ Texas SW Med Ctr Dallas, Dallas, TX 75390 USA

[3] Tokyo Inst Psychiat, Tokyo, Japan

[4] Mayo Clin, Scottsdale, AZ USA

来源：

ACTA NEUROPATHOLOGICA | 2009年 / 117卷 / 02期

关键词：

Parkinson's disease; surgery; Deep brain stimulation; Gene therapy; Transplantation; Dementia with Lewy bodies; diagnosis; therapy; clinical trial; alpha-Synuclein; Lewy bodies; incidental Lewy body disease; Biopsy; Olfactory bulb; DEEP BRAIN-STIMULATION; PARKINSONS-DISEASE; CLINICAL-DIAGNOSIS; DEMENTIA; COMPLICATIONS; PATHOLOGY; ACCURACY; NEUROPATHOLOGY; DYSFUNCTION; NUCLEUS;

D O I：

10.1007/s00401-008-0450-7

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Involvement of the olfactory bulb by Lewy-type alpha-synucleinopathy (LTS) is known to occur at an early stage of Parkinson's disease (PD) and Lewy body disorders and is therefore of potential usefulness diagnostically. An accurate estimate of the specificity and sensitivity of this change has not previously been available. We performed immunohistochemical alpha-synuclein staining of the olfactory bulb in 328 deceased individuals. All cases had received an initial neuropathological examination that included alpha-synuclein immunohistochemical staining on sections from brainstem, limbic and neocortical regions, but excluded olfactory bulb. These cases had been classified based on their clinical characteristics and brain regional distribution and density of LTS, as PD, dementia with Lewy bodies (DLB), Alzheimer's disease with LTS (ADLS), Alzheimer's disease without LTS (ADNLS), incidental Lewy body disease (ILBD) and elderly control subjects. The numbers of cases found to be positive and negative, respectively, for olfactory bulb LTS were: PD 55/3; DLB 34/1; ADLS 37/5; ADNLS 19/84; ILBD 14/7; elderly control subjects 5/64. The sensitivities and specificities were, respectively: 95 and 91% for PD versus elderly control; 97 and 91% for DLB versus elderly control; 88 and 91% for ADLS versus elderly control; 88 and 81% for ADLS versus ADNLS; 67 and 91% for ILBD versus elderly control. Olfactory bulb synucleinopathy density scores correlated significantly with synucleinopathy scores in all other brain regions (Spearman R values between 0.46 and 0.78) as well as with scores on the Mini-Mental State Examination and Part 3 of the Unified Parkinson's Disease Rating Scale (Spearman R -0.27, 0.35, respectively). It is concluded that olfactory bulb LTS accurately predicts the presence of LTS in other brain regions. It is suggested that olfactory bulb biopsy be considered to confirm the diagnosis in PD subjects being assessed for surgical therapy.

引用

页码：169 / 174

页数：6

共 40 条

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