Although Alzheimer's disease may involve both the substantia nigra and
the striatum, there is little information concerning the relationship
between the resulting abnormalities in these reciprocally interconnec
ted regions of the brain. We have examined the correlation between pla
que density in the striatum and counts of neurons and neurofibrillary
tangles in the pars compacta of the substantia nigra, in 12 cases of '
'pure'' Alzheimer's disease (i.e. without clinical or neuropathologica
l evidence of Parkinson's or cortical Lewy body disease) and 11 normal
controls. Diffuse plaques in the striatum and neurofibrillary tangles
in the substantia nigra were consistent findings in all of the Alzhei
mer brains. However, quantitation did not reveal a statistically signi
ficant correlation between the density of striatal plaques and the num
bers of either neurofibrillary tangles or neurons in the substantia ni
gra. Although the mean number of neurons in the substantia nigra of Al
zheimer brains was lower than that in controls, the difference did not
reach statistical significance. We suggest that previous assessments
of substantial loss of nigral neurons in Alzheimer's disease may have
been skewed by the inclusion of cases with coexistent cortical Lewy bo
dies.