Granulovacuolar degeneration in the hippocampal cortex of aging and demented patients - a quantitative study

The occurrence and topographic analysis of granulovacuolar degeneration (GVD) in the hippocampal cortex of mentally normal controls (75 cases) and patients with Alzheimer's dementia (AD; 17 cases which included Alzheimer's disease and senile dementia of Alzheimer type), multi-infarct dementia (MID; 16 cases), Pick's disease (PD; 5 cases) and atypical dementia [5 cases; non-Alzheimer, non-Pick dementia with Fahr's syndrome (NANPDF)] were investigated. GVD was rarely found in control cases below the age of 60 years. In elderly normal brains, the statistically most representative ranking order of predilection for GVD (in decreasing severity) was: in the 60 s, CA1>prosubiculum >CA2 (no GVD was found in the CA3 and CA4); in the 70 s, CA1>prosubiculum >CA2 >CA3>CA4; in the 80 s, CA1>prosubiculum >CA2>CA3>CA4; in the 90s, CA1>prosubiculum >CA2>CA3>CA4. In the brains of demented patients, the rank order for GVD was: for AD, CA1 >CA2>CA3> prosubiculum >CA4; for MID, CA1 > prosubiculum >CA2>CA3>CA4; for PD, CA1 >CA2>CA3> prosubiculum >CA4; and for atypical dementia (NANPDF), CA1>CA2> prosubiculum >CA3>CA4. The similarity of the predilection to ranking order was noted both in normal aged subjects and in MID as well as both in AD and in PD. The qualitative investigation disclosed that the affected neurons with GVD in the cases of AD were found in all the examined areas outside the hippocampus (gyrus praecentralis, temporal and occipital cortex, globus pallidus, amygdaloid nuclei, mammillary bodies, medial thalamic nuclei, red nuclei, nuclei basalis of Meynert, dentate nuclei and inferior olivary nuclei) and, contrary to the results in AD, there were no affected neurons with GVD in the cases of MID. The occurrence and distribution of GVD in demented patients were different in these respective disorders.