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An Autopsied Case of Slowly Progressive Pick's Disease Manabu IKEDA 1,2 , Kenji IKEDA 1 , Michiko ENDOH 3 , Chie HAGA 1 , Yoshihiko MIZUTANI 4 1Department of Neuropathology, Psychiatric Research Institute of Tokyo 2Hyogo Institute for Aging Brain and Cognitive Disorders 3Aoki Hospital 4Tokyo Metropolitan Matsuzawa Hospital Keyword: Pick's disease , Pick body , Neuronal process , Tau protein pp.1167-1171
Published Date 1994/11/15
DOI https://doi.org/10.11477/mf.1405903765
  • Abstract
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 A 67-year-old right-handed woman had a history of slowly progressive dementia. At the age of 48 she transiently experienced delusions, and was admitted to a mental hospital. During the subsequent 19 years, her predominant symptoms were personality changes such as euphoria and puerilism. At about 62 year of age, she started to lose spontaneity and develop a mild anomia. CT scan at age 59 revealed bilateral anterior temporal atrophy which was accentuated on the left side (Fig. 1). During her clinical course, “triebhafte Hemmungslossigkeit”, “stehende Symptome”, and “Gogi (word meaning) aphasia”, which are the characteristic symptoms of temporal dominant type of Pick's disease, were not detected.

 Neuropathologically, atrophy was mostly circumscribed in the left anterior temporal lobe (Fig 2). Microscopically, mild nerve cell loss with tissue rarefacation and subcortical gliosis were found in the anterior temporal lobes, especially on the left side, and, in lesser degree, also in the anterior parts of the orbital, rectal, cingulate, and insular gyri (Fig. 3, 4). Silver impregnations revealed numerous Pick's argentophilic bodies (PBs) in the abovementioned regions. All the PBs were intensely stained with anti-tau antibody (Fig. 5a). In addition, many tau-positive granules (neuronal processes named by Murayama) were visualized in the neuropil around PB -bearing cells (Fig. 5b). These granules were hard to detect by routine silver stainings.


Copyright © 1994, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-126X 印刷版ISSN 0488-1281 医学書院

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