Neuropathological Asymmetry in Argyrophilic Grain Disease

• Published in: Journal of neuropathology and experimental neurology 2010-07, Vol.69 (7), p.737-744
• Main Authors: Adachi, Tadashi, Saito, Yuko, Hatsuta, Hiroyuki, Funabe, Sayaka, Tokumaru, Aya M, Ishii, Kenji, Arai, Tomio, Sawabe, Motoji, Kanemaru, Kazutomi, Miyashita, Akinori, Kuwano, Ryozo, Nakashima, Kenji, Murayama, Shigeo
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; alpha-Synuclein - metabolism; Alzheimer Disease - pathology; Amyloid beta-Peptides - metabolism; Apolipoprotein E4 - genetics; Biological and medical sciences; Cognition Disorders - etiology; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases; Dementia - complications; Dementia - pathology; Female; Hippocampus - metabolism; Humans; Magnetic Resonance Imaging; Male; Medical sciences; Mental Status Schedule; Middle Aged; Nerve Degeneration - complications; Nerve Degeneration - pathology; Neurofibrillary Tangles - pathology; Neurology; Neuropil - pathology; Retrospective Studies; Statistics, Nonparametric; tau Proteins - metabolism; Tomography, X-Ray Computed
• ISSN: 0022-3069; 1554-6578
• DOI: 10.1097/NEN.0b013e3181e5ae5c

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-I-p-iodoamphetamine single photon emission computed tomographic images from 6 patients and F-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.