8 SECTION I Evaluating the Patient with Memory Loss or Dementia
In neocortex, major involvement of association Hippocampus
areas (especially temporoparietal and frontal)
with relative sparing of primary sensory cortices
Nucleus
(except olfactory) and motor cortices. Stippling
basalis
shows relative distribution of plaques
Olfactory
bulb
Precentral and
Cortex of postcentral gyri
frontal lobe Cortex of parietal
lobe
Amygdala
Locus caeruleus Raphe
nuclei
Cortex of
occipital lobe
Pathological involvement
of limbic system and subcortical
nuclei projecting to cortex
Superior
temporal lobe
Hippocampus Inferolateral
temporal lobe CA 2 CA 4
CA 3
CA 1 Subiculum
Amyloid -peptide
Dura mater deposition in cortical
and leptomeningeal
Piaarachnoid arterioles
I
II
III
SP
IV
V
Entorhinal Presubiculum
cortex
VI
In hippocampus, neurofibrillary tangles,
neuronal loss, and senile plaques primarily
NFT located in layer CA 1, subiculum, and entorhinal
cortex
In association cortex, neurofibrillary tangles (NFTs)
and synaptic and neuronal loss predominate in layer V.
Association cortex Senile plaques (SPs) occur in more superficial layers
FIGURE 2-1 The relative distribution of Alzheimers pathology in the brain. (Netter illustration from [Link]. Copyright Elsevier Inc.
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