Dysexecutive Alzheimer’s Disease with Lewy Body Disease Co-Pathology

doi:10.2174/1567205019666220308152219

摘要

背景：阿尔茨海默病可以不典型地表现为进行性执行障碍综合征 (dAD)，这种疾病优先影响年轻人并且经常被误诊，这凸显了进一步研究的必要性。目的：本研究的目的是描述两例年轻发病的 dAD 的临床、生前神经影像学和死后神经病理学特征，他们在尸检时显示出路易体病 (LBD) 共同病理学的证据。方法：回顾每位患者的临床病史、生前 MRI 和 PET 成像以及死后神经病理学数据。案例介绍：在这两个案例中都观察到了 dAD 的典型特征，包括与工作记忆和认知灵活性相关的任务的进行性和主要损害，缺乏主要的行为/个性变化，以及生前淀粉样蛋白和 tau 异常淀粉样蛋白和 tau 沉积的证据PET和死后神经病理学。在这两个个体中都观察到海马受累相对较少，这与许多临床非典型 AD 病例一致。其中一名患者在去世前几年出现了轻微的帕金森症状以及偏执和易怒。在这两种情况下，尸检时都观察到过渡性（脑干和边缘）LBD共病理学。结果和讨论：虽然 LBD 共病理在 AD 中并不少见，但在这些年轻发病的 dAD 病例（包括具有明显症状相关性的病例）中存在 LBD 病理，需要进一步调查更广泛的频率和潜在的病理生理学。结论：更好地了解哪些特定的年轻发病 AD 表型与 LBD 共病理学相关，将对咨询、治疗、临床试验登记和疾病机制知识具有重要意义。

关键词: 阿尔茨海默病、非典型 AD、路易体病、病例报告、神经病理学、MRI、PET。

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DOI https://dx.doi.org/10.2174/1567205019666220308152219	Print ISSN 1567-2050
Publisher Name Bentham Science Publisher	Online ISSN 1875-5828

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