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Pathologic Heterogeneity of Alzheimer's Disease

David M. A. Mann, PhD, MRCPath; Peter O. Yates, MD, FRCPath; Borys Marcyniuk, MSc
Arch Gen Psychiatry. 1988;45(10):962-963. doi:10.1001/archpsyc.1988.01800340090014.
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To the Editor.—  In their recent article in the Archives, Bondareff and colleagues1 argued for a pathologic heterogeneity of Alzheimer's disease (AD), the evidence for which came mainly from variations they found in the degree of cell loss from the nucleus locus ceruleus (nLC). In 46 patients (mean age, 77.73 ±9.42 years) with histopathologically verified AD, the authors counted the number of pigmented nLC neuron profiles in five 16-μm sections stained with cresyl fast violet that were cut from a single 1-cm block of nLC taken at the level of the pontine isthmus. A control group of 44 nondemented subjects (mean age, 80.84 ±7.65 years) was similarly analyzed. The mean number of nLC neurons per section in the patients with AD (67.9 ±31.2) was significantly lower (P<.001) than that in controls (110.0 ±16.6); on average, the number was reduced by 28.3%. The distribution of nLC neurons in the


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