NEUROPATHOLOGICAL CORRELATES OF BEHAVIORAL DISTURBANCE IN CONFIRMED ALZHEIMERS-DISEASE

Clinico-pathological correlations were examined in 54 patients with ne uropathologically verified Alzheimer's disease (AD) who were part of a prospective study. Behavioural disturbance was documented using an ex panded version of the Stockton Geriatric Rating Scale (SGRS). The subs cores for physical disability (P), apathy (A) and communication failur e (C) (summation score PAC) were closely correlated and were high in m ost patients during the late stages of illness. High PAC scores correl ated with an earlier onset and longer duration of illness, lower brain weight, more severe tangle pathology in the parahippocampal gyrus and the frontal and parietal neocortex, and lower neuron counts in the hi ppocampus and basal nucleus of Meynert. Features of the Kluver-Bucy sy ndrome (range behaviour and hypermetamorphosis) were significantly ass ociated with lower counts of large neurons in the parahippocampal gyru s and parietal neocortex, but not with more severe plaque or tangle fo rmation or with neuronal loss in the subcortical nuclei. No correction was made for multiple comparisons. These findings may signify decreas ed cortical inhibition in patients with relatively well preserved subc ortical structures who show features suggestive of the Kluver-Bucy syn drome. High PAC scores on the SGRS could reflect more advanced and wid espread cerebral pathology in the end stages of AD.