The nucleus basalis of Meynert in parkinsonism-dementia of Guam: a morphometric study

The nucleus basalis of Meynert (nbM) was studied morphometrically in three Guamanians with parkinsonism-dementia (PD) and in two Guamanian and two non-Guamanian controls. Paraffin-embedded blocks of the nbM were serially sectioned (20 microns thick) at increments of 200 microns so that a total of 24 sections (eight each from the anterior, intermediate and posterior sectors of the nbM) were studied. The mean cell density was determined for each sector and the diameter of 50 neurons, randomly chosen in the region of apparent maximal density, was calculated. A decrease of the mean cell density, due to the loss of neurons with diameters larger than 20 microns, was found in the PD cases compared to the controls. Two PD patients exhibited striking neuronal loss (65-95%) with predominant involvement of the intermediate and posterior sectors, while the third case showed only minimal neuronal loss in these sectors (15-40%). In both Guamanian and non-Guamanian controls large neurons (diameters greater than or equal to 20 microns) exceeded small neurons while the reverse was true in all sectors of the nbM for the PD cases. These data, while confirming a previous study reporting neuronal loss in the nbM of PD patients, underline the importance of detailed morphometric analysis of the different sectors of the nbM to recognize those patients in whom lesions are not uniformly distributed.