{"title":"Clinicopathological study of dementia with grains presenting with parkinsonism compared with a typical case.","authors":"Akira Arakawa, Ryoji Goto, Mana Higashihara, Yuko Hiroyoshi, Ayako Shioya, Manato Hara, Makoto Orita, Tomoyasu Matsubara, Renpei Sengoku, Masashi Kameyama, Aya M Tokumaru, Masato Hasegawa, Tatsushi Toda, Atsushi Iwata, Shigeo Murayama, Yuko Saito","doi":"10.1111/neup.12973","DOIUrl":null,"url":null,"abstract":"<p><p>Argyrophilic grain disease (AGD) is one of the major pathological backgrounds of senile dementia. Dementia with grains refers to cases of dementia for which AGD is the sole background pathology responsible for dementia. Recent studies have suggested an association between dementia with grains and parkinsonism. In this study, we aimed to present two autopsy cases of dementia with grains. Case 1 was an 85-year-old man who exhibited amnestic dementia and parkinsonism, including postural instability, upward gaze palsy, and neck and trunk rigidity. The patient was clinically diagnosed with progressive supranuclear palsy and Alzheimer's disease. Case 2 was a 90-year-old man with pure amnestic dementia, clinically diagnosed as Alzheimer's disease. Recently, we used cryo-electron microscopy to confirm that the tau accumulated in both cases had the same three-dimensional structure. In this study, we compared the detailed clinical picture and neuropathological findings using classical staining and immunostaining methods. Both cases exhibited argyrophilic grains and tau-immunoreactive structures in the brainstem and basal ganglia, especially in the nigrostriatal and limbic systems. However, Case 1 had more tau immunoreactive structures. Considering the absence of other disease-specific structures such as tufted astrocytes, astrocytic plaques and globular glial inclusions, lack of conspicuous cerebrovascular disease, and no history of medications that could cause parkinsonism, our findings suggest an association between AGD in the nigrostriatal system and parkinsonism.</p>","PeriodicalId":19204,"journal":{"name":"Neuropathology","volume":null,"pages":null},"PeriodicalIF":1.3000,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Neuropathology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/neup.12973","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/4/1 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Argyrophilic grain disease (AGD) is one of the major pathological backgrounds of senile dementia. Dementia with grains refers to cases of dementia for which AGD is the sole background pathology responsible for dementia. Recent studies have suggested an association between dementia with grains and parkinsonism. In this study, we aimed to present two autopsy cases of dementia with grains. Case 1 was an 85-year-old man who exhibited amnestic dementia and parkinsonism, including postural instability, upward gaze palsy, and neck and trunk rigidity. The patient was clinically diagnosed with progressive supranuclear palsy and Alzheimer's disease. Case 2 was a 90-year-old man with pure amnestic dementia, clinically diagnosed as Alzheimer's disease. Recently, we used cryo-electron microscopy to confirm that the tau accumulated in both cases had the same three-dimensional structure. In this study, we compared the detailed clinical picture and neuropathological findings using classical staining and immunostaining methods. Both cases exhibited argyrophilic grains and tau-immunoreactive structures in the brainstem and basal ganglia, especially in the nigrostriatal and limbic systems. However, Case 1 had more tau immunoreactive structures. Considering the absence of other disease-specific structures such as tufted astrocytes, astrocytic plaques and globular glial inclusions, lack of conspicuous cerebrovascular disease, and no history of medications that could cause parkinsonism, our findings suggest an association between AGD in the nigrostriatal system and parkinsonism.
霰粒肿(AGD)是老年性痴呆的主要病理背景之一。谷粒性痴呆指的是以谷粒性痴呆为唯一病理背景的痴呆病例。最近的研究表明,谷物痴呆与帕金森病之间存在关联。本研究旨在介绍两例谷粒性痴呆的尸检病例。病例1是一名85岁的男性,表现为失忆性痴呆和帕金森病,包括姿势不稳、向上凝视麻痹、颈部和躯干僵硬。患者被临床诊断为进行性核上性麻痹和阿尔茨海默病。病例 2 是一名 90 岁的纯失忆性痴呆患者,临床诊断为阿尔茨海默病。最近,我们利用低温电子显微镜证实,两个病例中累积的 tau 具有相同的三维结构。在本研究中,我们使用经典染色法和免疫染色法比较了详细的临床表现和神经病理学结果。两个病例的脑干和基底节,尤其是黑质和边缘系统都出现了霰粒肿和 tau 免疫反应结构。不过,病例1有更多的tau免疫反应结构。考虑到没有其他疾病特异性结构,如束状星形胶质细胞、星形胶质斑块和球状胶质包涵体,没有明显的脑血管疾病,也没有可能导致帕金森氏症的药物史,我们的研究结果表明黑质系统中的AGD与帕金森氏症之间存在关联。
期刊介绍:
Neuropathology is an international journal sponsored by the Japanese Society of Neuropathology and publishes peer-reviewed original papers dealing with all aspects of human and experimental neuropathology and related fields of research. The Journal aims to promote the international exchange of results and encourages authors from all countries to submit papers in the following categories: Original Articles, Case Reports, Short Communications, Occasional Reviews, Editorials and Letters to the Editor. All articles are peer-reviewed by at least two researchers expert in the field of the submitted paper.