轴突漏是阿尔茨海默病关键性的神经病理改变

Axonal Leakage is a Key Neuropathological Change in Alzheimer's Disease

目的探讨轴突病变在阿尔茨海默病(Alzheimer’s disease,AD)发病机制中的作用。方法采用人死亡后脑细胞轴突转运功能恢复方法和神经示踪技术分析38例个体的不同脑区(个体死亡时间均小于8 h),其中26例为AD患者,另12例非AD患者被设为对照。结果AD患者脑出现重要的神经病理改变———轴突漏(axonal leakage)。轴突漏常伴随肿胀的轴突和轴突膨体,且与传统的神经病理改变———斑块和神经原纤维缠结有明显的相关性。结论轴突漏可能是AD关键性的神经病理改变,不但可能导致斑块的产生和神经原纤维缠结的形成,而且可能是AD认知障碍的主要原因。

Objective To explore the role of axonopathy in the neuropathological mechanism of Alzheimer＇s disease （AD）. Methods The morphological changes of axons were obseruved in the various brain areas from 26 AD patients and 12 non-demented aged subjects and controls using a postmortem tracing technique. Results A new neuropathological change-＂axonal leakage＂ in the brains of AD patients was identified, which was accompanied by swellings of varicosities and axons, and was related to the degree of senile plaques and neurofibrillary tangles. Conclusion Axonal leakage might be a key neuropathological change, and probably lead to the formation of plaques and neurofibrillary tangles, and may also play a causative role in the cognitive deficit in AD.