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Department of Internal Medicine, Neurology Division (Dr. Zweig), the Research Office (Dr. Cardillo), and the Department of Psychiatry and Behavioral Sciences (Dr. Giere), VA Medical Center, Reno, University of Nevada School of Medicine, Reno, NV; the Institute of Pathology (Dr. Cohen), Case Western Reserve University School of Medicine, Cleveland, OH; and the Department of Pathology (Dr. Hedreen), The Johns Hopkins University School of Medicine, Baltimore, MD.
We compared numbers of neuronal profiles in the locus ceruleus (LC) from sections of brainstem in 13 patients with Parkinson's disease (PD) without concurrent Alzheimer's disease (AD) with counts from age-matched controls and from patients with PD and concurrent AD. We also evaluated the relationships between presence of dementia or LC neuronal loss and additional pathologic measures related to dementia in PD. Among patients with PD without concurrent AD, the presence of dementia was associated with significantly lower LC neuronal counts (at all anatomic levels); greater neuronal loss within the ventral tegmental area, nucleus basalis of Meynert, and possibly the medial (but not the lateral) substantia nigra pars compacta; and more Lewy bodies in the anterior cingulate gyrus. Correlations between lower LC neuronal counts and these other pathologic measures were generally positive and often significant. We conclude that dementia in PD is associated with pathologic involvement of multiple extranigral neuronal populations.
Address correspondence and reprint requests to Dr. R.M. Zweig, LSU Medical Center, 1501 Kings Highway, Shreveport, LA 71130-3932.
Supported by the Medical Research Service, US Department of Veterans Affairs; US Public Health Service NIH NS 20471, NS 07179, AG 05146; and AG 08992.
Received May 28, 1992. Accepted for publication in final form September 4, 1992.
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