The vascular factor in Alzheimer's disease: A study in Golgi technique and electron microscopy

Although the etiopathological background of Alzheimer's disease (AD) is mostly associated with the deposition of Αβ-peptide, the hyperphosphorylation of τ protein, the synaptic pathology and the mitochondrial alterations, the vascular factor may play substantial role in plotting the multifactorial pattern of the disease. We attempted to study the blood capillaries in the hippocampus, the acoustic, the visual and the parietal cortex in twelve early cases of Alzheimer's disease. Samples were processed for Golgi silver impregnation technique and electron microscopy. The morphological findings were compared with normal controls. The study of the brain capillaries in cases of AD, revealed numerous fusiform dilatations, tortuosities, abnormal branching and fusion, though the morphometric estimation revealed a decrease of the number of capillaries per mm3 in comparison with normal control brains. The ultrastructural study revealed mitochondrial abnormalities in the endothelial cells of a substantial number of capillaries and marked degeneration of the pericytes. Perivascular microglial proliferation was also prominent in the hippocampus and the parietal lobe. Our findings both in Golgi staining and electron microscopy plead in favor of the essential role that the microvascular alterations may play in the broad pathogenetic spectrum of AD.