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NEUROLOGY 1988;38:1694
© 1988 American Academy of Neurology

The distribution of neuritic plaques and acetylcholinesterase staining in the amygdala in Alzheimer's disease

H. R. Brashear, MD, M. S. Godec, MD and J. Carlsen, MD

Departments of Neurology and Behavioral Medicine and Psychiatry, University of Virginia School of Medicine, Charlottesville, VA.

The relationship between neuritic plaque formation in Alzheimer's disease and cholinergic innervation of brain regions is unclear. Many neuritic plaques are found in the amygdala, which also receives dense cholinergic innervation from the ventral forebrain, predominantly to the basolateral complex. To determine whether the regional distribution of neuritic plaques is related to the pattern of cholinergic innervation, we studied serial sections through the amygdala of four patients with Alzheimer's disease and four neurologically normal patients. We compared acetylcholinesterase reactivity, neuritic plaques stained with thioflavine S, and cytoarchitectural features in adjacent sections. Neuritic plaque counts were high in most amygdaloid nuclei but were significantly lower in the most acetylcholinesterase-positive region, the lateral portion of the basal nucleus of the amygdala. Acetylcholinesterase reactivity was reduced in the Alzheimer's cases, but the basal nucleus was easily recognized by the characteristic large neurons. The morphology of neuritic plaques also differed in the various regions. These results show that neuritic plaques occur to varying degrees in all nuclei of the amygdala, but are significantly less frequent in the region that receives the most prominent innervation from the cholinergic ventral forebrain.

Address correspondence and reprint requests to Dr. Brashear, Department of Neurology - Box 394, University of Virginia Medical Center, Charlottesville, VA 22908.

Supported in part by NIH Grant 07298.

Received December 24, 1987. Accepted for publication in final form May 19, 1988.




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