レンズ核と錐体路の関係について—神経病理学的資料を中心として

The Relationship of Lenticular Nucleus to Pyramidal Tract with Especial Reference to Neuropathologic Material

　錐体外路運動系の重要な中枢である線状体と淡蒼球，つまりレンズ核から下降する線維のうら，中脳黒質，とくにその網様層（reticular zone）を通過するもののあることはほぼ確実でありますが，それからさきの下降路についてはいくつかの説があります。しかし端的にいいますと，今日なお謎につつまれたままであるといえましよう。これは臨床神経学をはじめ，神経解剖学や神経生理学にとつても重大な関心事でありますのに，誠に不思議なことであります。ここで長年この方面の研究をすすめてこられた小川名誉教授を前にして，専門家でもなければ，またオーソドックスに検索をすすめてきたわけでもない私が話をするのは心臓が強すぎるかもしれませんが，本日の講演会はいわばお祭りでもありますし，それに私は私なりに，かねがねこの問題について興味と関心をもち続けてき，またここで多少の見透しをえたといえなくもないと考えましたので，あえてとりあげるしだいであります。

　資料は4つの脳を中心としていますが，私がはじめてこの問題に深い興味をおぼえました例からまずのべてみたいと思います。

　The relationship of the lenticular nucleus tothe pyramidal tract with especial reference to the neuropathologic material has been discussed. The latter comprized 4 autopsy cases; 1 of protracted insulin-shock death of the schizophrenic with decortication syndrome for 3 months of the total duration of the latter disorders (1st case); 1 of double athetosis with 22 years of the total clinical course (2nd case) ; 1 of olivo-ponto-cerebellar atrophy with Parkinsonian features at the terminal stage and about 12 years of the total clinical course (3rd case); 1 of olivo-ponto-cerebellar atrophy with 4 years and 8 months of the total clinical course expired accidentally by the pneumoencephalography (4th case).

　The putamen was bilaterally and severely involved in both 1st and 3rd cases in which the nerve-fiber bundles of the globus pallidus in particular were degenerated. In both 2nd and 4th cases, on the other hand, the globus pallidus were, more or less, disintegrated bilaterally, while the putamen was free from lesion. Although the changes varied from the case to case according to the total durations of the diseases, fat granule cells in the '1st case and gliosis in the 2nd, 3rd and 4th cases developed symmetrical bilaterally in the following regions, without exception; the reticular zone of the substantia nigra, the cerebral peduncle of the midbrain, and the pyramidal tract from the brain stem to the spinal cord.

　As a consequence, a possibility of descending fivers with comparatively smaller calibers from the lenticular nucleus to the pyramidal tract of both brain stem and spinal cord has been cautiously suggested.