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Background: TAR DNA-binding protein 43 (TDP-43) has been identified as a major disease protein in frontotemporal lobar degeneration. More recently, TDP-43 proteinopathy has also been observed in Alzheimer's disease (AD) with a characteristic distribution of TDP-43 predominantly in the mesial temporal lobe, and to a lesser degree in the neocortical areas. AD subjects with psychotic symptoms (AD+P) represent a subgroup characterized by greater impairment of frontal cortex-dependent cognitive functions and more severe frontal cortical neuropathology. The aim of this study is to determine whether there is an association between TDP-43 pathology and AD+P. We hypothesized that TDP-43 pathology would be more frequent in AD+P than in AD without psychosis. Methods: We studied the presence and distribution of TDP-43 pathology by immunohistochemistry in the dentate gyrus (DG) and prefrontal cortex (FC) of postmortem brain specimens from 68 subjects with a primary neuropathologic diagnosis of AD as determined by the Neuropathology Core of the University of Pittsburgh Alzheimer's Disease Research Center. Results: Forty-five (66%) subjects were classified as AD+P. Fourteen (20.6%) subjects had TDP-43 pathology in DG, eight (11.8%) had TDP-43 pathology in FC, and six (8.8%) had TDP-43 pathology in both regions. TDP-43 in DG was not significantly associated with AD+P. However, TDP-43 in FC demonstrated a trend toward reduced likelihood of psychosis (p = 0.068). TDP-43 pathology in DG, but not FC, was significantly associated with greater age at death and longer duration of illness. Conclusions: Our findings indicate that there was no association between concomitant TDP-43 pathology in DG or FC and AD+P.
机译:背景:TAR DNA结合蛋白43(TDP-43)已被确定为额颞叶变性的主要疾病蛋白。最近,在阿尔茨海默氏病(AD)中也观察到TDP-43蛋白病,其特征在于TDP-43的特征性分布主要分布在颞中叶,而在新皮层区域的分布较小。患有精神病性症状(AD + P)的AD受试者代表一个特征为额叶皮质依赖性认知功能受损更大,额叶皮质神经病理更为严重的亚组。这项研究的目的是确定TDP-43病理与AD + P之间是否存在关联。我们假设,AD + P中的TDP-43病理比无精神病的AD中更常见。方法:我们采用免疫组织化学方法研究了68例死者脑标本的齿状回(DG)和额叶前皮层(FC)中TDP-43病理的存在和分布,该样本由AD的神经病理学核心确定为AD的主要神经病理学诊断匹兹堡大学阿尔茨海默氏病研究中心。结果:四十五名(66%)受试者被分类为AD + P。 DG中有14名(20.6%)的受试者患有TDP-43病理,在FC中有八名(11.8%)的患者具有TDP-43病理,两个地区中有6名(8.8%)的患者具有TDP-43病理。 DG中的TDP-43与AD + P无显着相关性。但是,FC中的TDP-43表现出降低精神病可能性的趋势(p = 0.068)。 DG(而非FC)中的TDP-43病理学与更高的死亡年龄和更长的病程显着相关。结论:我们的研究结果表明,DG或FC的伴随TDP-43病理学与AD + P没有关联。

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