RT Journal Article
SR Electronic
T1 Inverse relation between Braak stage and cerebrovascular pathology in Alzheimer predominant dementia
JF Journal of Neurology, Neurosurgery & Psychiatry
JO J Neurol Neurosurg Psychiatry
FD BMJ Publishing Group Ltd
SP 654
OP 657
DO 10.1136/jnnp.67.5.654
VO 67
IS 5
A1 Jonathan M R Goulding
A1 David F Signorini
A1 Sanjukta Chatterjee
A1 James A R Nicoll
A1 Janice Stewart
A1 Robert Morris
A1 G Alistair Lammie
YR 1999
UL http://jnnp.bmj.com/content/67/5/654.abstract
AB The most common neuropathological substrates of dementia are Alzheimer’s disease, cerebrovascular disease, and dementia with Lewy bodies. A preliminary, retrospective postmortem analysis was performed of the relative burden of each pathology in 25 patients with predominantly Alzheimer’s disease-type dementia. Log linear modelling was used to assess the relations between ApoE genotype, Alzheimer’s disease, and cerebrovascular disease pathology scores. Sixteen of 18 cases (89%) with a Braak neuritic pathology score ⩽4 had, in addition, significant cerebrovascular disease, or dementia with Lewy bodies, or both. There was a significant inverse relation between cerebrovascular disease and Braak stage (p=0.015). The frequency of the ApoE-ε4 allele was 36.4%. No evidence was found for an association between possession of the ApoE-ε4 allele and any one pathological variable over another. In this series most brains from patients with dementia for which Alzheimer’s disease is the predominant neuropathological substrate also harboured significant cerebrovascular disease or dementia with Lewy bodies. The data suggest that these diseases are perhaps pathogenetically distinct, yet conspire to produce the dementing phenotype.