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Department of Neurology, University of Massachusetts Medical Center, Worcester, MA.
The extent and location of neuronal losses necessary or sufficient to produce dementia in patients with Alzheimer's Disease (AD) is unknown. To approach this question, we studied synaptic terminals in postmortem brain tissue utilizing immunohistochemical techniques. We used antibodies against two proteins found in synaptic terminalssynapsin I and synaptophysinas synaptic markers in the hippocampal complexes of eight patients with autopsy-proven AD and eight nondemented control subjects. Quantitative microscopy measured the regional density of synaptic staining. All AD patients showed a striking decrease in synaptic staining in the outer half of the molecular layer of the dentate gyrus compared with control brains, where the density of synaptic terminals was uniform throughout. In an additional patient with progressive degenerative dementia but without plaques or tangles on neuropathologic examination, similar depletion of synaptic staining was seen in the dentate gyrus. Quantitative densitometric analyses confirmed the focal decrease in synaptic staining in the outer half of the molecular layer in demented patients. We also found a slight increase in synaptic staining in the inner half of this layer.
Address correspondence and reprint requests to Dr. Hamos, Department of Neurology, University of Massachusetts Medical Center, 55 Lake Avenue North, Worcester, MA 01655.
Supported in part by grants from the Massachusetts Department of Public Health, the Massachusetts Alzheimer's Disease Research Center (NIA grant P50 AG05134), the Sterling Morton Research Fund, and the Stanley and Harriet Friedman Research Fund.
Presented in part at the fortieth annual meeting of the American Academy of Neurology, Cincinnati, OH, April 1988.
Received July 22, 1988. Accepted for publication in final form September 29, 1988.
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