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Brain and Nerve No to Shinkei Volume 44, Issue 5 （May 1992）

Brain and Nerve 脳と神経 44巻5号（1992年5月発行）

Japanese English

原著

進行性核上性麻痺の視床病変について The Thalamic Changes of Progressive Supranuclear Palsy 天野直二 ¹ , 長友秀樹 ¹ , 横井晋 ¹ , 柳下三郎 ² , 斉藤惇 ³ , 水谷俊雄 ⁴ Naoji Amano ¹ , Hideki Nagatomo ¹ , Susumu Yokoi ¹ , Saburo Yagishita ² , Atsushi Saitoh ³ , Toshio Mizutani ⁴ ¹神奈川県総合リハビリテーションセンター精神神経科 ²神奈川県総合リハビリテーションセンター精神神経科病理 ³神奈川県立精神医療センターせりがや病院 ⁴東京都老人総合研究所神経病理 ¹Division of Neuro-psychiatry, The Kanagawa Rehabilitation Center ²Division of Pathology, The Kanagawa Rehabilitation Center ³Kanagawa Psychiatric Medical Center, Serigaya Hospital ⁴Department of Neuropathology, Tokyo Metropolitan Institute of Gerontology キーワード： progressive supranuclear palsy , thalamic changes , subcortical dementia , neuropathology Keyword: progressive supranuclear palsy , thalamic changes , subcortical dementia , neuropathology pp.421-428

発行日 1992年5月1日 Published Date 1992/5/1

DOI https://doi.org/10.11477/mf.1406900331

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Abstract 文献概要
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　臨床病理学的に進行性核上性麻痺と診断された6剖検例で視床の変化について神経病理学的な検討を行った。その結果，高度に神経細胞が脱落する症例とアルツハイマー神経原線維変化（NFT）が多数出現する症例がみられた。高度な神経細胞の脱落は，内側核を中心に外側核，腹側核の背側部に及び，線維性グリオーシスを伴い，内髄板の線維の消失もみられた。NFTは，内側核群や網様核，不確帯に多く，ついで腹側核群にも出現する傾向があった。視床病変は症例によりその質や程度にかなりの差異を認めるが，皮質下性痴呆や進行した臨床期によくみられる周期性の昏迷様状態，さらには末期の無動無言症候群に機能的に大きく関与する重要な部位の1つと考えられ，今後さらに検討する必要性を指摘した。

This report is to investigate neuropathological changes of the thalamus observed in progressive supranuclear palsy. Six autopsy cases were examined. They were 5 males and a female, whose age was between 57 and 72 years old. They devel-oped dementia in various degrees and three of the cases showed periodic stuporous state and akineticmutism in the last stage. The paraffined thin-sections were stained with hematoxylin-eosin, luxol-fast-blue, Holzer, modified Bielschowsky, Gallyas and anti-tau stainings. The histological changes were evaluated in the aspects of neuronal loss, fibrillary gliosis and neurofibrillary tangles.

In conclusion, there were three types in six cases. The first was seen in two cases and that there appeared many Alzheimer's neurofibrillary tangles (NFTs) in medial nuclei, lateral and ventral nuclei as well as zona incerta and reticular nucleus. The second was observed in two cases and that the loss of nerve cells was severe, especially in medial nuclei and the dorsal part of lateral and ventral nuclei and fibrillary gliosis was observed beyond the lesions ofneuronal loss. The third was that the appearance of NFTs was moderate in number and neuronal loss was minimal. Moreover, neuronal loss and NFTs of zona incerta were common in these cases. Argento-philic fibrillary inclusions were observed in the neuropil and astrocytes in all cases.

It is important to investigate the correlations between neuropathological changes and clinical manifestations, especially in the peculiar type of dementia observed in PSP. The thalamic changes of PSP may play an important role in causing stupor-ous state and akinetic mutism as well as subcortical dementia.