伴随性病理对肌缩性侧面硬化症的贡献与认知或行为异常
Hideyuki Moriyoshi1,2, Akio Akagi1, Yuichi Riku1,2
1Department of Neuropathology, Institute for Medical Science of Aging, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan.
BMC neurology
|December 3, 2025
概括
像阿尔茨海默病这样的并发症病理在老年ALS患者中常见,这些患者有认知问题. 这些情况会导致行为和记忆问题,即使没有严重的TDP-43脑病理.
科学领域:
- 神经学 神经学
- 病理学 病理学 病理学
- 老年病的医生 老年病的医生
背景情况:
- 肌缩性侧面硬化症 (ALS) 经常涉及认知和行为变化.
- 皮质中的TARDNA结合蛋白-43 (TDP-43) 病理与这些异常有关.
- 与ALS相关的认知衰退中并发病态的作用尚未完全理解.
研究的目的:
- 调查ALS患者的临床病理特征,这些患者有认知或行为异常.
- 评估临床症状与并发性病理之间的关联.
- 确定并发性疾病对ALS认知和行为症状的影响.
主要方法:
- 检查了29例ALS尸检病例,其中包括认知/行为异常.
- 评估的并发性病理:阿尔茨海默病 (AD),阿尔吉罗菲尔粒细胞疾病 (AGD),勒维体痴呆症 (DLB) 和初级与年龄相关的病 (PART).
- 评估皮质TDP-43病理的存在及其与临床症状的关系.
主要成果:
- 在29例ALS病例中,有17例患有并发性病理 (AD,AGD或PART).
- 伴随性病理与年龄较大有关,但没有明显的临床症状.
- 在这两组中,行为异常和记忆障碍是常见的;伴随性病理严重影响了认知,即使没有皮质TDP-43.
- 在没有并发性病理的ALS病例中注意到海马硬化,可能会独立导致记忆障碍.
结论:
- 患有认知/行为问题的老年ALS患者经常表现出并发性病理.
- 像AD,AGD和PART这样的并发症可以在ALS中驱动认知/行为异常,而不管皮质TDP-43.
- 在ALS中的海马硬化可能独立地导致记忆障碍.
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