Neuropathological asymmetry in argyrophilic grain disease.
The presence of argyrophilic grains in the neuropil is associated with a form of dementia. We investigated morphological asymmetry in 653 consecutive autopsy patients from a general geriatric hospital (age [mean +/- SD] = 81.1 +/- 8.9 years), focusing on those from patients with advanced argyrophilic grain disease. Paraffin sections of the bilateral posterior hippocampi were immunostained with anti-phosphorylated tau and anti-4-repeat tau antibodies and by the Gallyas-Braak method. In a side-to-side comparison, asymmetry was defined when either the extent or the density of argyrophilic grains was different. Of the 653 subjects, 65 (10%) had Stage 3 argyrophilic grain disease, and 59 (90.8%) showed histopathological asymmetry. Antemortem computed tomographic images (n = 24), magnetic resonance imaging scans (n = 8), and combined computed tomographic and magnetic resonance images (n = 15) were available; images from 20 of the 47 subjects showed asymmetry that correlated with the histopathological asymmetry. Cerebral cortical asymmetry consistent with the histopathology was also visible in N-isopropyl-123I-p-iodoamphetamine single photon emission computed tomographic images from 6 patients and 18F-labeled fluorodeoxyglucose positron emission tomographic images from 2 patients. Thus, asymmetric involvement of the medial temporal lobe in patients with advanced argyrophilic grain disease may represent a diagnostic feature and contribute to distinguishing dementia with grains from Alzheimer disease.
Department of Neuropathology, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.
Tadashi
T
Adachi
Yuko
Y
Saito
Hiroyuki
H
Hatsuta
Sayaka
S
Funabe
Aya M
AM
Tokumaru
Kenji
K
Ishii
Tomio
T
Arai
Motoji
M
Sawabe
Kazutomi
K
Kanemaru
Akinori
A
Miyashita
Ryozo
R
Kuwano
Kenji
K
Nakashima
Shigeo
S
Murayama
D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000473:pathology; D016229:Amyloid beta-Peptides / Q000378:metabolism; D053327:Apolipoprotein E4 / Q000235:genetics; D003072:Cognition Disorders / Q000209:etiology; D003704:Dementia / Q000150:complications* / Q000473:pathology*; D005260:Female; D006624:Hippocampus / Q000378:metabolism; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008609:Mental Status Schedule; D008875:Middle Aged; D009410:Nerve Degeneration / Q000150:complications* / Q000473:pathology*; D016874:Neurofibrillary Tangles / Q000473:pathology*; D019581:Neuropil / Q000473:pathology*; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D014057:Tomography, X-Ray Computed; D051844:alpha-Synuclein / Q000378:metabolism; D016875:tau Proteins / Q000378:metabolism
D016229:Amyloid beta-Peptides; D053327:Apolipoprotein E4; D051844:alpha-Synuclein; D016875:tau Proteins