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Early Olfactory Involvement in Alzheimer’s Disease

Published online by Cambridge University Press:  02 December 2014

S. Christen-Zaech ,
R. Kraftsik ,
O. Pillevuit ,
M. Kiraly ,
R. Martins ,
K. Khalili  and
J. Miklossy
S. Christen-Zaech
Affiliation:
University Institute of Pathology
R. Kraftsik
Affiliation:
1011, CHUV, Lausanne, Switzerland, Institute of Cellular Biology and Morphology
O. Pillevuit
Affiliation:
Division of Neuropathology, 1011, CHUV, Lausanne, Switzerland, Department of Oto-Rhino-Laryngology, Head and Neck Surgery
M. Kiraly
Affiliation:
University of Lausanne, 1005 Lausanne, Switzerland, Institute of Physiology
R. Martins
Affiliation:
University of Lausanne, 1005 Lausanne, Switzerland, University Department of Surgery
K. Khalili
Affiliation:
Hollywood Private Hospital, Nedlands, Perth 6009, Western Australia, and Center for Neurovirolgy and Cancer Biology, Temple University, Philadelphia, USA
J. Miklossy
Affiliation:
University Institute of Pathology Hollywood Private Hospital, Nedlands, Perth 6009, Western Australia, and Center for Neurovirolgy and Cancer Biology, Temple University, Philadelphia, USA
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Abstract

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Background:

In Alzheimer’s disease (AD) the olfactory system, including the olfactory bulb, a limbic paleocortex is severely damaged. The occurrence of early olfactory deficits and the presence of senile plaques and neurofibrillary tangles in olfactory bulb were reported previously by a few authors. The goal of the present study was to analyze the occurrence of AD-type degenerative changes in the peripheral part of the olfactory system and to answer the question whether the frequency and severity of changes in the olfactory bulb and tract are associated with those of the cerebral cortex in AD.

Material and Methods:

In 110 autopsy cases several cortical areas and the olfactory bulb and tract were analyzed using histo- and immunohistochemical techniques. Based on a semiquantitative analysis of cortical senile plaques, neurofibrillary tangles and curly fibers, the 110 cases were divided into four groups: 19 cases with severe (definite AD), 14 cases with moderate, 58 cases with discrete and 19 control cases without AD-type cortical changes.

Results:

The number of cases with olfactory involvement was very high, more than 84% in the three groups with cortical AD-type lesions. Degenerative olfactory changes were present in all 19 definite AD cases, and in two of the 19 controls. The statistical analysis showed a significant association between the peripheral olfactory and cortical degenerative changes with respect to their frequency and severity (P<0.001). Neurofibrillary tangles and neuropil threads appear in the olfactory system as early as in entorhinal cortex.

Conclusion:

The results indicate a close relationship between the olfactory and cortical degenerative changes and indicate that the involvement of the olfactory bulb and tract is one of the earliest events in the degenerative process of the central nervous system in AD.

Résumé:

RÉSUMÉ:Contexte:

Le système olfactif incluant le bulbe olfactif, qui fait partie du paléocortex limbique, est sévèrement atteint dans la maladie d’Alzheimer (MA). L’existence d’un déficit olfactif précoce et la présence de plaques séniles et d’amas neurofibrillaires dans le bulbe olfactif ont été rapportés par quelques auteurs. Le but de cette étude était d’analyser les changements dégénératifs de type MA en périphérie du système olfactif et de déterminer si la fréquence et la sévérité des changements dans le bulbe et le pédoncule olfactif sont associées à ceux observés dans le cortex cérébral dans la MA.

Matériel et méthodes:

Plusieurs zones corticales ainsi que le bulbe et le pédoncule olfactif ont été analysés au moyen de techniques d’histo et d’immunohistochimie chez 110 cas d’autopsie. Les 110 cas ont été divisés en quatre groupes, selon une analyse semi-quantitative des plaques séniles corticales, des amas neurofibrillaires et des fibres incurvées: 19 cas atteints de changements corticaux de type MA sévères (MA certaine), 14 cas de changements modérés, 58 cas de changements discrets et 19 témoins sans changements.

Résultats:

Le nombre de cas avec atteinte olfactive était très élevé, soit plus de 84% dans les trois groupes de cas ayant des lésions de type MA. Des changements olfactifs dégénératifs étaient présents chez les 19 cas de MA certaine et chez deux des 19 témoins. L’analyse statistique a montré une association significative entre les changements dégénératifs olfactifs et corticaux quant à leur fréquence et à leur sévérité (P < 0,001). Les amas neurofibrillaires et de fibres tortueuses apparaissent dans le système olfactif aussi précocement que dans le cortex entorhinal.

Conclusions:

Ces résultats indiquent qu’il existe une relation étroite entre les changements dégénératifs olfactifs et corticaux et que l’atteinte du bulbe et du pédoncule olfactif est un des événements les plus précoces dans le processus dégénératif au niveau du système nerveux central dans la MA.

Type
Research Article
Information
Canadian Journal of Neurological Sciences , Volume 30 , Issue 1 , February 2003 , pp. 20 - 25
Copyright
Copyright © The Canadian Journal of Neurological 2003

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