老年痴呆の脳amyloid angiopathy—Alzheimer病との比較

CEREBRAL AMYLOID ANGIOPATHY IN SENILE DEMENTIA:A COMPARISON BETWEEN SENILE DEMENTIA AND ALZHEIMER DISEASE

　抄録　高度の老化性痴呆16例（老年痴呆8，脳血管性痴呆5，両者の合併例3）の脳髄を，amyloidangiopathyとその他の老年性変化に重点をおいて神経病理学的に検索した。そして，その結果を，以前に報告^2）したAlzheimer病10例の所見と比較した。amyloid angiopathyは老年痴呆でも全例に認められ，その分布はAlzheimer病の分布と大差がなかった。老化性痴呆のamyloid angiopathyの出現頻度は，年齢よりも疾患との関連がより強く認められた。老年痴呆の1例と合併例の1例では，amyloid angiopathyが著しく高度であった。その他の老年性変化（老人斑，Alzheimer原線維変化，神経細胞脱落）は，Mey-nert核の変化も含めて，老年痴呆ではAlzheimer病に比較して軽度の症例が多かった。また脳重は，Alzheimer病では老年痴呆に比べて軽いものが多かった。

The brain was examined neuropathologically in 16 elderly patients with severe dementia (8 cases of senile dementia, 5 of vascular dementia and 3 of combined senile-vascular dementia), focussing an attention on amyloid angiopathy and and other senile changes. The findings were compared with the results obtained in 10 cases of Alzheimer disease described previously.

Amyloid angiopathy was noted in all cases of senile dementia and its distribution was similarto that of Alzheimer disease. The frequency of cerebral amyloid angiopathy in elderly patients with severe dementia was more closely related to diease than to age. One patient each with senile dementia and combined senile-vascular dementia showed markedly advanced amyloid angiopathy.

The cases who showed other senile changes (e. g., senile plaque, Alzheimer neurofibrillary tangle,nerve cell deciduation) were frequently seen in patients with Alzheimer disease than in those with senile dementia. Further, there was a ten-dency that the brain weight was lighter in patients with Alzheimer disease than in those with senile dementia.