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Pathological Heterogeneity of the Precentral Gyrus in Pick’s Disease: A Study of 16 Autopsy Cases

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Abstract

This report concerns the upper motor neuron involvement in 16 autopsy cases of Pick disease with Pick bodies, including 11 cases reported by us previously. Prominent, circumscribed atrophy of the precentral gyrus, conspicuously in the lower portion, was noted in one case. Loss of Betz cells and astrocytosis of the precentral gyrus layer V were encountered in 15 cases (94%) and eight cases (50%), respectively. Appearance of Pick bodies and ballooned neurons in the precentral gyrus layer V was confirmed in seven cases (44%). Degeneration of the pyramidal tract in the medulla oblongata was noted in all 15 cases in which this structure was examined. Pyramidal signs were observed in four (67%) of the six cases that were neurologically sufficiently examined: hyperreflexia in four cases (67%), spasticity in one case (17%). Babinski sign was not encountered in any of the six cases. In all four cases having pyramidal signs, degeneration of the pyramidal tract was observed. In contrast, two cases having degeneration of the pyramidal tract did not develop pyramidal signs. In Pick’s disease with Pick bodies, obvious involvement of the precentral gyrus and pyramidal tract was not previously noticed. Furthermore, we suggest that pyramidal signs in Pick’s disease with Pick bodies have been underestimated.

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Acknowledgements

We wish to express our gratitude to Dr. O. Yokota (Tokyo Institute of Psychiatry) for his valuable advice. We also wish to thank Mr. Y. Shoda and Ms E. Matsui for assisting us in photography.

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Authors and Affiliations

  1. Department of Laboratory Medicine and Pathology, Tokyo Metropolitan Matsuzawa Hospital, 2-1-1, Kamikitazawa, Setagaya-ku, 156-0057, Tokyo, Japan

    Kuniaki Tsuchiya

  2. Department of Neuropathology, Tokyo Institute of Psychiatry, Tokyo, Japan

    Kuniaki Tsuchiya, Chie Haga & Haruhiko Akiyama

  3. Department of Pathology, Brain Research Institute, Niigata University, Niigata, Japan

    Yue-Shan Piao, Akiyoshi Kakita & Hitoshi Takahashi

  4. Department of Psychiatry, National Hospital Organization Shimofusa Psychiatric Medical Center, Chiba, Japan

    Tatsuro Oda, Koji Hori & Itaru Tominaga

  5. Department of Neurology, Tsukuba University, Ibaragi, Japan

    Akihide Mochizuki

  6. Department of Laboratory Medicine, National Center Hospital for Mental, Nervous and Muscular Disorders, Tokyo, Japan

    Kunimasa Arima

  7. Department of Neurology, National Hospital Organization Sagamihara National Hospital, Kanagawa, Japan

    Kazuko Hasegawa

  8. Department of Pathology, Kanagawa Rehabilitation Center, Kanagawa, Japan

    Saburo Yagishita

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  1. Kuniaki Tsuchiya
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Correspondence to Kuniaki Tsuchiya.

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Tsuchiya, K., Piao, YS., Oda, T. et al. Pathological Heterogeneity of the Precentral Gyrus in Pick’s Disease: A Study of 16 Autopsy Cases. Acta Neuropathol 112, 29–42 (2006). https://doi.org/10.1007/s00401-005-0028-6

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