摘要
神经精神症状(NPS)是痴呆综合征的主要组成部分,因此,最近被列入痴呆诊断标准的要点。几乎所有阿尔茨海默病(AD)普遍出现NPS,加上其对患者和照料者的不良影响,与其相对应的事实是现有很少安全有效的治疗,这是由于在某种程度上我们不完全了解NPS的神经生物学特性。在这篇综述中,我们描述了AD典型的病理改变,包括负担的扩展和进展,分子和细胞的完整性的影响,功能性的后果和与NPS相关的脑区萎缩的和与特定的NPS评估相关的范围。因此清楚地表明,NPS是潜在的脑部神经退行性疾病的基本表现,而不是简单地反映患者疾病的继发性反应。此外,纳入大多数终末期病人的样本的神经病理学的研究,这也许不能正确的代表可能已经在早期阶段甚至对AD诊断之前存在特定的NPS的病理生理环境。NPS复杂的性质和较高的患病率,加上缺乏安全有效的药物疗法,极需要继续研究其神经病理学和神经化学以及影像和其他相关的方法,来进一步提高我们对NPS的神经生物学的理解。
关键词: 攻击性,淀粉样蛋白,抑郁症,神经原纤维缠结,神经元缺失,精神病,神经递质。
Current Alzheimer Research
Title:Neuropsychiatric Disturbances in Alzheimer’s Disease: What Have We Learned from Neuropathological Studies?
Volume: 13 Issue: 10
Author(s): Debby Van Dam, Yannick Vermeiren, Alain D. Dekker, Petrus J.W. Naudé, Peter P. De Deyn
Affiliation:
关键词: 攻击性,淀粉样蛋白,抑郁症,神经原纤维缠结,神经元缺失,精神病,神经递质。
摘要: Neuropsychiatric symptoms (NPS) are an integral part of the dementia syndrome and were therefore recently included in the core diagnostic criteria of dementia. The near universal prevalence of NPS in Alzheimer’s disease (AD), combined with their disabling effects on patients and caregivers, is contrasted by the fact that few effective and safe treatments exist, which is in part to be attributed to our incomplete understanding of the neurobiology of NPS. In this review, we describe the pathological alterations typical for AD, including spreading and evolution of burden, effect on the molecular and cellular integrity, functional consequences and atrophy of NPS-relevant brain regions and circuits in correlation with specific NPS assessments. It is thereby clearly established that NPS are fundamental expressions of the underlying neurodegenerative brain disease and not simply reflect the patients’ secondary response to their illness. Neuropathological studies, moreover, include a majority of end-stage patient samples, which may not correctly represent the pathophysiological environment responsible for particular NPS that may already be present in an early stage, or even prior to AD diagnosis. The burdensome nature and high prevalence of NPS, in combination with the absence of effective and safe pharmacotherapies, provide a strong incentive to continue neuropathological and neurochemical, as well as imaging and other relevant approaches to further improve our apprehension of the neurobiology of NPS.
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Cite this article as:
Debby Van Dam, Yannick Vermeiren, Alain D. Dekker, Petrus J.W. Naudé, Peter P. De Deyn , Neuropsychiatric Disturbances in Alzheimer’s Disease: What Have We Learned from Neuropathological Studies?, Current Alzheimer Research 2016; 13 (10) . https://dx.doi.org/10.2174/1567205013666160502123607
DOI https://dx.doi.org/10.2174/1567205013666160502123607 |
Print ISSN 1567-2050 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-5828 |
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