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Neuronal pathology in the nucleus basalis and associated cell groups in senile dementia of the Alzheimer's type

Possible role in cell loss

Departments of Neurology and Neurological Surgery (Neurology) and Anatomy and Neurobiology (Dr. Saper), Washington University School of Medicine, St. Louis. MO: and the Departments of Physiology and Psychiatry (Dr. German) and Pathology (Dr. White). University of Texas, Southwestern Medical School, Dallas, TX.

The loss of cortical cholinergic innervation in senile dementia of the Alzheimer's type (SD AT) is associated with cell loss in the nucleus basalis and related cell groups (magnocellular basal nucleus, MBN). We examined MBN in Nissl-, acetylcholinesterase- and thioflavin S-stained sections in two cases of SDAT and in four control brains. Using these sensitive methods, senile plaques were easily demonstrated in MBN, and most MBN neurons showed neurofibrillary degeneration as an early change. Cell loss appeared to be due to maturation of neurofibrillary tangles, displacing normal cellular contents. In contrast to theories that the cell loss in MBN represents retrograde degeneration due to axonal injury in the cerebral cortex, MBN neuronal perikarya may be involved by the same primary processes as cortical neurons.

Address correspondence and reprint requests to Dr. Saper, Department of Pharmacological and Physiological Sciences, University of Chicago, 947 East 58th Street, Chicago, IL 60637.

Supported by USPHS grants NS18669, Teacher-Investigator Development Award NS00631, and by a McKnighl Scholar Award to C. B. S; and by USPHS grant NS20030 to D. C. G.

Accepted for publication November 14, 1984

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