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Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA Drs. Arriagada and Hedley-Whyte)
Department Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA (Drs. Growdon and Hyman).
We studied the accumulation of neurofibrillary tangles (NFTs) and senile plaques (SPs) in 10 Alzheimer's disease patients who had been examined during life. We counted NFTs and SPs in 13 cytoarchitectural regions representing limbic, primary sensory, and association cortices, and in subcortical neurotransmitter-specific areas. The degree of neuropathologic change was compared with the severity of dementia, as assessed by the Blessed Dementia Scale and duration of illness. We found that (1) the severity of dementia was positively related to the number of NFTs in neocortex, but not to the degree of SP deposition; (2) NFTs accumulate in a consistent pattern reflecting hierarchic vulnerability of individual cytoarchitectural fields; (3) NFTs appeared in the entorhinal cortex, CA1/subiculum field of the hippocampal formation, and the amygdala early in the disease process; and (4) the degree of SP deposition was also related to a hierarchic vulnerability of certain brain areas to accumulate SPs, but the pattern of SP distribution was different from that of NFT.
Address correspondence and reprint requests to Dr. Bradley T. Hyman, Department of Neurology, Massachusetts General Hospital, Boston, MA 02114.
Presented in part at the 41st annual meeting of the American Academy of Neurology, Boston, MA, April 1991.
Supported by NIH grants AG08487, P50 AG05134, the Seevak-Hoffman fund, and the Brookdale Foundation.
Received July 30, 1991. Accepted for publication in final form August 28, 1991.
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