The Progression of Alzheimer’s Disease from Limbic Regions to the Neocortex: Clinical, Radiological and Pathological Relationships

Alzheimer’s disease (AD) is characterised by the gradual accumulation of neurofibrillary pathology in selected regions of the brain. Earlier studies indicate that the accumulation of neurofibrillary tangles is associated both with decline in patient’s cognitive performance as well as with medial tem...

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Bibliographic Details
Published in:Dementia and geriatric cognitive disorders 1999-03, Vol.10 (2), p.115-120
Main Authors: Nagy, Zs, Hindley, N.J., Braak, H., Braak, E., Yilmazer-Hanke, D.M., Schultz, C., Barnetson, L., King, E.M.-F., Jobst, K.A., Smith, A.D.
Format: Article
Language:English
Subjects:
Aged
Alzheimer Disease - diagnostic imaging
Alzheimer Disease - pathology
Alzheimer Disease - psychology
Biological and medical sciences
Cognition
Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases
Disease Progression
Female
Humans
Limbic System - diagnostic imaging
Limbic System - pathology
Male
Medical sciences
Memory
Neocortex - diagnostic imaging
Neocortex - pathology
Neurofibrillary Tangles - pathology
Neurology
Neuropsychological Tests
Original Research Article
Prospective Studies
Severity of Illness Index
Temporal Lobe - pathology
Tomography, X-Ray Computed
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Summary:Alzheimer’s disease (AD) is characterised by the gradual accumulation of neurofibrillary pathology in selected regions of the brain. Earlier studies indicate that the accumulation of neurofibrillary tangles is associated both with decline in patient’s cognitive performance as well as with medial temporal lobe atrophy on CT scans. There are also indications that progression through the pathological stages of AD is associated with decline in cognitive functions. The results of this study indicate that progression of disease, especially beyond the boundaries of the limbic regions, is associated with marked decline in the cognitive performance of patients suffering from AD. However the clinical manifestations of early pathological stages are not so well defined. We also found that the atrophy of the medial temporal lobe on CT scans is related to the progression of pathology. Atrophy is most apparent when the disease reaches its isocortical stages and is not marked in the limbic stages of the disease. The additive effect of pathologies co-existing with AD is apparent in reduced cognitive scores, while the atrophy of limbic structures, as measured on CT scans, seems to be mainly attributable to AD-related pathology.
ISSN:1420-8008
1421-9824
DOI:10.1159/000017111