Patients with Alzheimer's disease (AD) often show emotional, motivational, and memory disturbances which may have morphological substrates that include the amygdaloid complex. Neuropathological studies in other limbic areas have recently been enhanced by immunocytochemical studies with Alz 50 antibody. Therefore, we examined the distribution of Alz 50 immunoreactive (Alz 50-IR) neuritic plaques (NP) and neurofibrillary tangles (NFT) in the amygdala in AD cases, in one aged patient with Down's syndrome, and in controls of similar ages. In all AD cases numerous NP and variable numbers of NFT were observed and a distinctive subregional anatomical distribution of NP and Alz 50-IR neuropil in the amygdala existed, whereas no similar selective topography for NFT or Alz 50-IR neurons was found. A high density of NP was demonstrated in the ventromedial aspects of the basolateral and corticomedial nuclear regions. There was no correlation with the pattern of cholinergic innervation. There was, however, a correspondence between intraamygdaloid- and amygdaloid-hippocampal connections and regions of high NP density. Our findings support the concept that the disease process may occur along anatomically defined pathways, and the amygdala may be a central participant in this process. © 1991.
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