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Brain and Nerve No to Shinkei Volume 45, Issue 11 （November 1993）

Brain and Nerve 脳と神経 45巻11号（1993年11月発行）

Japanese English

原著

老年者剖検例におけるレビー小体の偶発的出現の意義—加齢およびパーキンソン病との関連について Incidental Occurrence of Lewy Bodies in the Brains of Elderly Patients : The Relevance to Aging and Parkinson's Disease 若林孝一 ¹ , 高橋均 ¹ , 小栁清光 ² , 生田房弘 ¹ Koichi Wakabayashi ¹ , Hitoshi Takahashi ¹ , Kiyomitsu Oyanagi ² , Fusahiro Ikuta ¹ ¹新潟大学脳研究所実験神経病理学部門 ²新潟大学脳研究所脳疾患標本センター ¹Department of Pathology, Brain Research Institute, Niigata University ²The Center for Materials of Brain Diseases, Brain Research Institute, Niigata University キーワード： Parkinson's disease , Lewy body , substantia nigra , locus ceruleus , quantitative investigation Keyword: Parkinson's disease , Lewy body , substantia nigra , locus ceruleus , quantitative investigation pp.1033-1038

発行日 1993年11月1日 Published Date 1993/11/1

DOI https://doi.org/10.11477/mf.1406900556

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Abstract 文献概要
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　臨床的にパーキンソン病（P病）とは診断されず剖検により偶発的にレビー小体を認めた例（偶発例）の意義を明らかにする目的から，死亡時10〜89歳の1452剖検例について検討した。その結果，偶発例27例のレビー小体出現部位はP病におけるレビー小体の好発部位に一致し，その頻度は10歳台0％，20〜40歳台0.2％，50歳台O．7％，60歳台4.4％，70歳台4.7％，80歳台6.5％であった。また，神経細胞の定量的検討（偶発例8例，P病9例，対照9例）では，偶発例の黒質および青斑核のメラニン含有神経細胞数は対照と同程度のものからP病に近い低値を示すものまで認められ，その平均値は黒質では対照の83％，青斑核では77％に減じていた。これらのことは，レビー小体の出現が加齢と密接に関連していること，また，偶発例においてレビー小体の出現と神経細胞脱落とが関連していることを示唆する。すなわち，偶発例におけるレビー小体は病的意義を有する構造物であり，偶発例はP病の早期の変化を示す例，あるいはpresymptomaticな例を含む集団であると考えられた。

The Lewy body (LB) is a cytoplasmic neuronal inclusion that is constantly found in the substantia nigra and locus ceruleus, and other specific brain regions in Parkinson's disease (PD). In the present study, the significance of nonparkinsonian cases in which the LBs were an incidental finding was inves-tigated.

In 1,452 autopsy series (age range, 1~89 years), 27 incidental cases of LBs and 21 patients with PD were found. The age-specific prevalence of inciden-tal LBs steadily increased from 0.7 % to 6.5 % between the sixth and ninth decades. The distribu-tion of LBs in incidental cases was similar to that in PD.

The number of neurons in the substantia nigra and locus ceruleus was determined in 8 incidental cases (age range, 60~81 years), 9 patients with PD (range, 56~81 years) and 9 control subjects (range, 60~81 years). In incidental cases, the average numbers of pigmented neurons in the substantia nigra and locus ceruleus was 83 % and 77 % of those in control subjects, respectively. In PD, the average numbers of pigmented neurons in the substantia nigra and locus ceruleus was 28 % and 19 % those of controls, respectively. However, the number of nonpigmented neurons in the substantia nigra was not reduced in incidental cases and PD.

From the above findings, it is suggested that there exists a close relationship between the occurrence of LBs and aging. However, in the brains of elderly patients, incidental LBs were considered to be patho-logical findings rather than simple aging phenome-non. Therefore, it has been suggested that inciden-tal cases may represent early and presymptomatic cases of PD.