Summary
Seven cases of senile dementia of Alzheimer type (SDAT) with unusual clinico-pathological findings are reported. The patients showed neuronal loss in laminar pattern, with gliosis exclusively confined to the CA1 of the hippocampus, the area of the hippocampal gyrus (entorhinal cortex) and medial occipitotemporal cortex. This change was more pronounced in the oral region. The subcortical white matter showed more pronounced fibrillary gliosis than loss of myelin. Both Alzheimer's neurofibrillary tangles and senile plaques were less marked than those usually seen in SDAT. The mental disturbance started after the age of 65 in all patients. The main clinical feature was marked character change in addition to disturbance of cognitive function. Cranial computed tomography showed marked dilatation of the oral portion of the inferior horn of the lateral ventricle in the early stage. It was apparent that although the cases in this group could be incorporated within in the spectrum of SDAT, they could also be considered to represent a variant of SDAT. This group could contribute to an understanding of the clinico-pathological spectrum of SDAT as well as indicating ways of managing such patients.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Berlin L (1949) Presenile sclerosis (Alzheimer's disease) with features resembling Pick's disease. Arch Neurol Psychiatry 61:369–384
Delay J, Brion S (1962) Les démences tardives. Masson, Paris
Ditter SM, Mirra SS (1987) Neuropathologic and clinical features of Parkinson's disease in Alzheimer's disease patients. Neurology 37:754–760
Duvernoy HM (1988) The human hippocampus. An atlas of applied anatomy. J. F. Bergmann Verlag, Munich
Duyckaerts C, Derouesne C, Signoret JL, Gray F, Escourolle R, Castaigne P (1985) Bilateral and limited amygdalohippocampal lesions causing a pure anmesic syndrome. Ann Neurol 18:314–319
Goodman L (1953) Alzheimer's disease. A clinicopathologic analysis of twenty three cases with a theory of pathogenesis. J Nerv Ment Dis 118:97–130
Herzog AG, Kemper TL (1980) Amygdaloid changes in aging and dementia. Arch Neurol 37:625–629
Jellinger K (1989) Pathology of Parkinsons's syndrome In: Calne DB (ed) Handbook of experimental pharmacology, Vol 88, Springer, Berlin Heidelberg New York, 47–112
Khachaturian ZS (1985) Diagnosis of Alzheimer's disease. Arch Neurol 42:1097–1105
Matsushita M (1983) Circumscribed cerebral atrophy and lesions of cerebral white matter in Alzheimer's disease. Pathol Clin Med (Tokyo) 1:459–471
McMenemey WH (1963) The dementias and progressive diseases of the basal ganglia. In: Blackwood W, McMenemey WH, Meyer A, Norman RM (eds) Greenfield's neuropathology, 2nd edn. Arnold, London, pp 520–580
Miyoshi K, Kamiya S (1978) A case of presenile dementia with neurofibrillary tangles and circumscribed fronto-temporal atrophy. Clin Neurol (Tokyo) 15:827–833
Oda M, Matsuoka S, Fujisawa K, Hirai S, Yoshikawa M, Endo H (1978) An autopsy case of atypical presenile dementia with akinetic mute state from the relatively early stage. Jpn J Geriatr 15:587–592
Oyanagi S, Maeda T, Ikuta F (1975) An autopsy case of atypical presenile dementia with morphological features of Alzheimer's disease and Pick's disease. Psychiatr Neurol Jpn 77:19–27
Rothschild D, Kasanin J (1936) Clinicopathologic study of Alzheimer's disease. Arch Neurol Psychiatry 36:293–321
Seitelberger F, Jellinger K (1958) Umschriebene Gross-hirnatrophie bei Alzheimerscher Krankheit. Dtsch Z Nervenheilkd 178:356–379
Shibayama H, Hoshino T, Kobayashi H, Iwase S, Takenouchi Y (1978) An autopsy case of atypical senile dementia with atrophy of the temporal lobes. A clinical and histopathological report. Folia Psychiatr Neurol Jpn 32:285–298
Tariska I (1970) Circumscribed cerebral atrophy in Alzheimer's disease: a pathological study. In: Wolstenholme GEW, O'Connor M (eds) Alzheimer's disease and related conditions. Churchill, London, pp 51–74
Terry RD, Katzman R (1983) Senile dementia of the Alzheimer type: defining a disease. In: Katzman R, Terry RD (eds) Neurology of aging. Davis, Philadelphia, pp 51–84
Terry RD, Peck A, DeTeresa R, Schechter R, Horoupian DS (1981) Some morphometric aspects of the brain in senile dementia of Alzheimer type. Ann Neurol 10:184–192
Tomlinson BE, Henderson G (1976) Some quantitative cerebral findings in normal and demented old people. In: Terry R, Cershon S (eds) Neurobiology of aging. Raven Press, New York, pp 183–204
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Mizutani, T., Amano, N., Sasaki, H. et al. Senile dementia of Alzheimer type characterized by laminar neuronal loss exclusively in the hippocampus, parahippocampus and medial occipitotemporal cortex. Acta Neuropathol 80, 575–580 (1990). https://doi.org/10.1007/BF00307623
Received:
Revised:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00307623