Involvement of cortical glutamatergic mechanisms in senile dementia of the Alzheimer type (SDAT) has been investigated with quantitative ligand-binding autoradiography. The distribution and density of Na+-dependent glutamate uptake sites and glutamate receptor subtypes-kainate, quisqualate, and N-methyl-D-aspartate-were measured in adjacent sections of frontal cortex obtained postmortem from six patients with SDAT and six age-matched controls. The number of senile plaques was determined in the same brain region. [3H]Glutamate binding in SDAT subjects was unrelated to senile plaque number in superficial cortical layers (r = 0.104). These results indicate that in the presence of cortical glutamatergic terminal loss in SDAT plastic alterations occur in some glutamate receptor subtypes but not in others.Senile dementia of the Alzheimer type (SDAT) is characterized neuropathologically by neuronal cell loss, the presence of higher than normal densities of senile plaques, and the development of neurofibrillary tangles in neocortical and archicortical regions (1-3). Extensive neurochemical studies have indicated deficits in a number of neurotransmitters and neurotransmitter receptors in SDAT cerebral cortex (4-7). The relationship of these changes to the neuropathological progression of the disease, however, remains largely unknown.Glutamate is putatively the major excitatory transmitter of cortical pyramidal neurons (8), which mediate corticocortical and corticofugal neurotransmission (9). A loss of cortical pyramidal cells is a prominent feature of SDAT pathology (2, 3, 10); thus, cortical glutamatergic dysfunction may be a contributory factor in the pathophysiological progression of the disease. In rodents, glutamate receptormediated excitotoxicity in the cerebral cortex induces retrograde degeneration of cholinergic neurons in the nucleus basalis (11), supporting the suggestion that cortical cholinergic axon degeneration in SDAT may be a consequence of a primary cortical pathology (12 (14,15,(17)(18)(19)(20).Using quantitative ligand-binding autoradiography, we have measured the distribution and density of both highaffinity Na+-dependent glutamate-uptake sites and the three glutamate receptor subtypes in adjacent sections of frontal cortex from SDAT patients and age-matched controls. These neuropharmacological measures could be directly related to the neuropathological severity of the disease by quantification of senile plaque numbers in the same brain region.
MATERIALS AND METHODSBrains were obtained at postmortem from six subjects, mean age 84 ± 2 yr, who had no known neurological or neuropsychiatric disorders (two males, four females; postmortem delay 11-23 hr), and six clinically diagnosed SDAT patients, mean age 89 ± 2 yr (two males, four females; postmortem delay 3-15 hr). As part of an ongoing longitudinal study of SDAT, these patients were diagnosed antemortem according to the criteria set out in the Cambridge Diagnostic Examination for the Elderly (21). Eight of the twelve patients used in this stud...