The association of ventral tegmental area histopathology with adult dementia
R. M. Torack and J. C. Morris
Department of Pathology, Washington University School of Medicine, St Louis, MO 63110.
Six cases of adult dementia with mesolimbic pathology are reported. The
core clinical syndrome consists of parkinsonism, progressive dementia, and
behavioral disturbances (generally depression). The histopathologic
findings uniformly include a loss of pigmented neurons in the ventral
tegmental area plus neurofibrillary tangles and/or cell loss in the
entorhinal cortex and pyramidal cell layer of the hippocampus (perforant
pathway). Neuronal depletion in the ventral tegmental area frequently is
associated with similar cell loss in the adjacent substantia nigra and in
the locus ceruleus. The development of neurofibrillary tangles in the
perforant pathway occurs in the absence of senile plaques and is possibly
related to diminished dopaminergic input.
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