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The neuropathological changes associated with normal brain aging

P R Hof1, P Glannakopoulos, C Bouras

  • 1Fishberg Research Center for Neurobiology, Mount Sinai School of Medicine, New York, NY 10029-6574, USA.

Histology and Histopathology
|October 1, 1996
PubMed
Summary
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Neurofibrillary tangles in the entorhinal cortex occur in normal aging and Alzheimer's disease. Area 20 tangles may precede cognitive decline, showing brain aging heterogeneity.

Area of Science:

  • Neuropathology
  • Neuroscience
  • Aging Research

Background:

  • Neurofibrillary tangles and senile plaques are hallmarks of brain aging and Alzheimer's disease.
  • Understanding lesion distribution patterns is crucial for differentiating normal aging from disease states.

Purpose of the Study:

  • To examine neurofibrillary tangle and senile plaque distribution in normal aging versus mild cognitive impairment and Alzheimer's disease.
  • To identify specific brain regions vulnerable to neuropathology across cognitive statuses.

Main Methods:

  • Clinicopathological analysis of 1144 non-demented cases.
  • Comparison with reported data from mild cognitive impairment and Alzheimer's disease cases.
  • Quantitative assessment of neurofibrillary tangle and senile plaque densities.

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Main Results:

  • Layer II of the entorhinal cortex shows tangles in all cases, regardless of cognitive status.
  • Neocortical area 20 is prone to tangles in cognitively preserved elders, with substantial plaques in the neocortex of non-demented individuals.
  • Tangle density in entorhinal cortex layer II correlates with mild cognitive impairment; area 20 tangles correlate with Alzheimer's disease.

Conclusions:

  • Mesial and inferior temporal lobe structures are more affected in normal aging than previously thought.
  • Neurofibrillary tangle formation in area 20 may be a critical early step preceding Alzheimer's-like cognitive deficits.
  • Significant age-related heterogeneity exists in cerebral cortex vulnerability during normal brain aging.