Journal of Neurology, Neurosurgery, and Psychiatry 1988;51:842-849 The differential involvement of subcortical nuclei in senile dementia of Alzheimer's type

SUMMARY Cell counts have been performed on cholinergic subcortical nuclei, dorsal raphe nucleus, and locus caeruleus from up to 18 cases of Alzheimer's disease and 10 age-matched control subjects. In general, the extent of the cell loss in these structures was similar. In the basal nucleus the anteromedial subdivision was the least, and the posterior subdivision the most affected. A subgroup of demented subjects with Alzheimer's disease had a relatively preserved basal nucleus, and frontal lobe (CAT) choline acetyltransferase activities similar to those in control subjects, but significantly more neuronal loss in the locus caeruleus. Neuropathological changes in the neocortex of sub-jects with Alzheimer's disease are known to be accom-panied by a reduction in certain neurotransmitter substances or their marker enzymes, and this has stimulated examination of the subcortical sites associ-ated with their synthesis. The nucleus basalis of Mey-nert (NBM) in the substantia innominata (together with the medial septal nucleus (MSN) and the nucleu