title: Pathological heterogeneity of the precentral gyrus in Pick's disease: a study of 16 autopsy cases.
abstract: This report concerns the upper motor neuron involvement in 16 autopsy cases of Pick disease with Pick bodies, including 11 cases reported by us previously. Prominent, circumscribed atrophy of the precentral gyrus, conspicuously in the lower portion, was noted in one case. Loss of Betz cells and astrocytosis of the precentral gyrus layer V were encountered in 15 cases (94%) and eight cases (50%), respectively. Appearance of Pick bodies and ballooned neurons in the precentral gyrus layer V was confirmed in seven cases (44%). Degeneration of the pyramidal tract in the medulla oblongata was noted in all 15 cases in which this structure was examined. Pyramidal signs were observed in four (67%) of the six cases that were neurologically sufficiently examined: hyperreflexia in four cases (67%), spasticity in one case (17%). Babinski sign was not encountered in any of the six cases. In all four cases having pyramidal signs, degeneration of the pyramidal tract was observed. In contrast, two cases having degeneration of the pyramidal tract did not develop pyramidal signs. In Pick's disease with Pick bodies, obvious involvement of the precentral gyrus and pyramidal tract was not previously noticed. Furthermore, we suggest that pyramidal signs in Pick's disease with Pick bodies have been underestimated.
authors.affiliation: Department of Laboratory Medicine and Pathology, Tokyo Metropolitan Matsuzawa Hospital, 2-1-1, Kamikitazawa, Setagaya-ku, 156-0057, Tokyo, Japan. ktsuchi@jcom.home.ne.jp
authors.forename: Kuniaki
authors.initials: K
authors.lastname: Tsuchiya
authors.forename: Yue-Shan
authors.initials: YS
authors.lastname: Piao
authors.forename: Tatsuro
authors.initials: T
authors.lastname: Oda
authors.forename: Akihide
authors.initials: A
authors.lastname: Mochizuki
authors.forename: Kunimasa
authors.initials: K
authors.lastname: Arima
authors.forename: Kazuko
authors.initials: K
authors.lastname: Hasegawa
authors.forename: Chie
authors.initials: C
authors.lastname: Haga
authors.forename: Akiyoshi
authors.initials: A
authors.lastname: Kakita
authors.forename: Koji
authors.initials: K
authors.lastname: Hori
authors.forename: Itaru
authors.initials: I
authors.lastname: Tominaga
authors.forename: Saburo
authors.initials: S
authors.lastname: Yagishita
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Akiyama
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Takahashi
mesh_terms: D000368:Aged; D001344:Autopsy; D001921:Brain / Q000473:pathology*; D005260:Female; D005911:Gliosis / Q000473:pathology; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D009046:Motor Neurons / Q000473:pathology; D009410:Nerve Degeneration / Q000473:pathology; D020774:Pick Disease of the Brain / Q000473:pathology* / Q000503:physiopathology*; D011712:Pyramidal Tracts / Q000473:pathology*