Depression and Senile Dementia of the Alzheimer Type: Catecholamine Changes in the Locus coeruleus – Basis for Therapy

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Abstract
This paper describes the clinical, psychometric, neuropathological, and neurotransmitter studies on 8 patients selected from the ZÜrich study on dementia. It confirms the age-related loss of norepinephrine neurons in the locus coeruleus (LC) in control patients without neurological or psychiatric disease. A relationship between the incremental loss of LC neurons in patients with senile dementia (SDAT) and presenile dementia of the Alzheimer type and the increasing severity of the clinical disease was found. The morphological characteristics of altered Alzheimer neurons with enlarged somata and distorted shortened processes are described. The norepinephrine neurons in the LC of the 3 cases with depressive disorders, depression, Parkinson's disease with depression, and SDAT with depression, had in common severe LC norepinephrine cell losses and low levels of catecholamine-synthesizing enzyme signifying reduced norepinephrine levels. The significance of these findings in relation to the possible treatments of depression in complex coexistent diseases such as depression and SDAT are discussed.

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