Publication: The neuropathological changes associated with normal brain aging
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Date
1996
Authors
Hof, P.R. ; Giannakopoulos, P. ; Bouras, C.
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Publisher
Murcia : F. Hernández
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Description
Abstract
Neurofibrillary tangles and senile plaques are
common neuropathological features in both normal brain
aging and Alzheimer's disease. In order to examine the
patterns of lesion distribution in cerebral aging, we
review the clinicopathological analysis of 1144 nondemented
cases comparing their neuropathologic
features to that reported in cases with mild cognitive
impairment and cases with Alzheimer's disease.
Regardless of cognitive status, layer I1 of the entorhinal
cortex is involved with neurofibrillary tangle formation
in all of the cases, while the CA1 field of the hippocampus
and the subiculum are less consistently affected.
Neocortical area 20 is particularly prone to develop
neurofibrillary tangles in intellectually preserved elders,
whereas other neocortical areas are relatively spared.
Substantial senile plaque formation is seen in the
neocortex of non-demented cases. Quantitatively, mild
cognitive impairment is correlated with neurofibrillary
tangle densities in layer I1 of the entorhinal cortex, and
clinically overt Alzheimer's disease with neurofibrillary
tangle densities in area 20. In non-demented
centenarians, there is an early development of
neurofibrillary tangles in areas usually spared in the
course of the degenerative process in younger
individuals. These observations demonstrate that mesial
and inferior temporal lobe structures are affected more
frequently than originally thought in normal brain aging.
In this respect, neurofibrillary tangle formation in area
20 may represent a crucial step of the degenerative
process, because it may precede the emergence of the neuropsychological deficits characteristic of Alzheimer's
disease. In addition, this study reveals age-related
heterogeneity in the regional vulnerability of the cerebral
cortex during normal brain aging.
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