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Argyrophilic grain disease is common in older adults and may be a risk factor for suicide:a study of Japanese forensic autopsy cases

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Translational Neurodegeneration 2023年第1期12卷 654-665页

作者： Koji Yoshida Yukiko Hata Shojiro Ichimata keitaro okada Naoki Nishida Department of Legal Medicine Faculty of MedicineUniversity of Toyama2630 SugitaniToyama-shiToyama 930-0194Japan Tanz Centre for Research in Neurodegenerative Disease Krembil Discovery TowerUniversity of Toronto60 Leonard Ave Toronto OnTorontoON M5T 0S8Canada Department of Laboratory Medicine and Pathobiology University of TorontoTorontoONCanada.

Background Neuropathological diagnosis of argyrophilic grain disease(AGD)is currently based primarily on the combination of argyrophilic grain(AG)visualized using Gallyas-Braak silver staining,phosphorylated tau-positive pretangles,coiled bodies,and ballooned neuron *** AGD is common in patients with dementia and/or prominent psychiatric symptoms,whether it is a distinct neurological disease entity or a by-product of the aging process remains *** In 1449 serial forensic autopsy cases>40 years old(823 males and 525 females,aged 40-101 years,mean age 70.0±14.1 years),we examined the frequency and comorbid pathology of AGD cases and investigated the clini-cal appearance by comparing those with non-AGD cases using the propensity *** Of the 1449 cases,we detected 342 AGD cases(23.6%;mean age 79.7 years;177 males and 165 females).The AGD frequency and stage increased with age(P<0.001).Among AGD cases,80(23.4%)patients had dementia,and 51(15.2%)had a history of psychiatric hospital *** frequency of suicide and history of psychiatric disorders were significantly higher in AGD cases than in AGD-negative cases,matched for age,sex,and comorbidity pathol-ogy,with a relative risk of suicide of 1.72(1.30-2.26).The frequency of suicide was significantly higher in AGD cases than in non-AGD cases in female but not male *** relative risk of suicide increased to 2.27(1.20-4.30)and 6.50(1.58-26.76)in AGD patients with Lewy and progressive supranuclear palsy pathology,respectively,and decreased to 0.88(0.38-2.10)in those with advanced AD *** AGD cases,23.4%had dementia;however,the difference was not significant after controlling for age,sex,and comorbid *** Our study demonstrated that AGD is a significant and isolated risk factor for psychiatric hospital visits and suicide *** older adults,AGs may contribute to the progression of functional impairment of the limbic system,which leads to psychiatric dis

关键词： Amygdala Argyrophilic grains Dementia Forensic autopsy Psychiatric disorder Suicide

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