Cortical atrophy in senile dementia of the Alzheimer type is mainly due to a decrease in cortical length
A prospective study was undertaken to select mentally normal old subjects and patients with senile dementia of the Alzheimer type (SDAT). The test score of Blessed et al. (1968) (BTS) was used to determine the severity of mental impairment. A pathologic study confirmed the diagnosis of either SDAT or normal brain aging at postmortem examination in 12 cases. The cortical area and the cortical perimeter of the different cerebral lobes were measured on 1-cm-thick coronal sections using a semiautomatic image analyzer. Cortical length and thickness were calculated using perimeter and area values. BTS was significantly correlated with both the area (r=0.7695,P=0.003) and the length (r=0.7421,P=0.006) of the temporal cortex. There was no significant correlation between BTS and thickness of the temporal cortex (r=0.559,P=0.059). These results show that reduction of length is one of the major determinants of cortical atrophy. Although this has to be confirmed by histological study, they favor the hypothesis of a column-selective atrophy in SDAT which should be considered in the interpretation of the microscopic data.
Key wordsSenile dementia of the Alzheimer type Cortical atrophy Temporal lobe Morphometry
Unable to display preview. Download preview PDF.
- Blessed G, Tomlinson BE, Roth M (1968) The association between quantitative measures of dementia and of senile change in the cerebral gray matter of elderly subjects. Br J Psychiatry 114:797–811Google Scholar
- Brun A, Englund E (1981) Regional pattern of degeneration in Alzheimer's disease: neuronal loss and histopathological grading. Histopathology 5:549–564Google Scholar
- Hubbard BM, Anderson JM (1981) A quantitative study of cerebral atrophy in old age and senile dementia. J Neurol Sci 50:135–145Google Scholar
- Hyman BT, Van Hoesen GW, Damasio AR (1984) Pathological changes in Alzheimer's disease specifically disrupt hippocampal connections. J Neuropathol Exp Neurol 43:306Google Scholar
- Jellinger K, Riederer P (1983) Dementia in Parkinson's disease and (pre)senile dementia of Alzheimer type: morphological aspects and changes in the intracerebral MAO activity. In: Hassler RG, Christ JF (eds) Advances in neurology, vol 40. Raven Press, New York, pp 199–210Google Scholar
- Mountjoy CQ, Roth M, Evans JR, Evans HM (1983) Cortical neuronal counts in normal elderly controls and demented patients. Neurobiol Aging 4:1–11Google Scholar
- Terry RD, Peck A, DeTeresa R, Schechter R, Horoupian DS (1981) Some morphometric aspects of the brain in senile dementia of the Alzheimer type. Ann Neurol 10:184–192Google Scholar