The Contribution of Altered Synapses in the Senile Plaque: An Electron Microscopic Study in Alzheimer's Dementia*†

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Abstract
Recent ultrastructural studies of cerebral biopsies from patients with Alzheimer's presenile dementia have elucidated certain morphological features of neurofibrillary changes and of the senile plaque. Terry (1), Kidd (2), and Terry et al. (3) have described in detail the fine structure of the neurofibrillary change and of the senile plaque which they found to be composed of an extracellular core of fibrils, resembling amyloid, surrounded by cytoplasmic processes containing fibrils, multilamellar bodies, and mitochondria. Kidd has also observed dendritic, post-synaptic processes filled with abnormal neurofibrils (helices); Krigman et al (4) have noticed enlarged presynaptic endings containing dense bodies, while Luse and Smith (5) indicated that in the region of the senile plaque, the axon terminals are enlarged and contain “abnormally large and dense vesicles” and fibrils. These findings have been confirmed in the present study. In addition, changes in axons, pre-synaptic and post-synaptic endings, and dendrites, in or around senile plaques, not heretofore reported, have been noted. These findings may be significant in view of the proven role of synapses in establishing functional contacts between neurons and the suggested implication of synapses in learning and memory storage (6–9).

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