臨床神経学

第48回日本神経学会総会

<シンポジウム7-4>認知症「治療を展望したAlzheimer病の早期診断―MCIから初期Alzheimer病へ」
高齢者ブレインバンクでの軽度認知障害(MCI)・早期アルツハイマー病(AD)

村山 繁雄1), 齊藤 祐子2)

1)東京都老人総合研究所 高齢者ブレインバンク〔〒173-0015 東京都板橋区栄町35-2〕
2)東京都老人医療センター剖検病理科〔同上〕

The pathological study of mild cognitive impairment (MCI) was very few. Consecutive 1,628 autopsy cases from the Brain Bank for Aging Research (BBAR) with the mean age of 80.7 years were employed for this study. All the cases were studied with the BBAR protocol (www.mci.gr.jp/BrainBank/) and clasasified into Braak's seven neuforibrillary tangle (NFT) stages (0- VII) and four senile plaque (SP) stages (0- C). CDR from the most recent 545 cases were independently evaluated by three neurologists in two different occasions. Among the 1,628 cases, 10.1% fulfilled morphological requirement of Alzheimer disease, consisting of NFT stage equal to or more than IV and SP stage equal to or more than C. Postmortem assessment of CDR was possible for 486 cases amoug 545 cases with frozem half brain and 57 cases were classified into CDR 0.5. CDR 0.5 group was clinicopathologically classified into 33 cases with degenerative changes, nine cases with vascular changes and four cases with combined degenerative and vascular changes. Only 6 among the 57 cases presented pure AD pathology. These data indicate that the pathological background of MCI is not always Alzheimer disease and combined pathology with AD as well as non-AD pathology should be carefully ruled out. For this purpose, ADNI (Alzheimer Disease Neuroimage Initiative) approach could be useful to identify MCI stage of AD.

(臨床神経, 47:912−914, 2007)
key words:神経原線維変化, 老人斑, レビー小体, 嗜銀顆粒, 脳血管障害

(受付日:2007年5月16日)