{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T06:29:27Z","timestamp":1769581767956,"version":"3.49.0"},"reference-count":52,"publisher":"Cambridge University Press (CUP)","issue":"4","license":[{"start":{"date-parts":[[2009,7,9]],"date-time":"2009-07-09T00:00:00Z","timestamp":1247097600000},"content-version":"unspecified","delay-in-days":6094,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Psychol. Med."],"published-print":{"date-parts":[[1992,11]]},"abstract":"<jats:title>Synopsis<\/jats:title><jats:p>Depressive symptoms have been reported in patients with mild to moderate Alzheimer's disease (AD). Recent evidence suggests that a noradrenergic deficit originating from neuronal degeneration in brainstem nuclei may represent an organic correlate of these disturbances. We examined the neuropathological changes in the locus coeruleus (LC), substantia nigra (SN), basal nucleus of Meynert and cortex of 52 patients (12 male, 40 female, mean age 83\u00b72 \u00b1 6\u00b74 years) with pathologically verified AD. Fourteen patients (1 male, 13 female) showed signs of depression. The majority of these patients suffered from severe physical disability or sensory impairment and developed persistent delusions, but had less cognitive impairment. Neuronal counts in the LC were significantly lower than in the 38 patients without depression (36\u00b79 \u00b1 14 \u00b70; 51\u00b74 \u00b1 28\u00b70 neuromelaninpigmented cells per section per nucleus;<jats:italic>F<\/jats:italic>= 3\u00b74, df = 1, 50,<jats:italic>P<\/jats:italic>= 0\u00b704). Neuron counts were higher in the basal nucleus of Meynert in depressed AD patients and there were no differences of the neuron numbers in the SN. Depression (main effect;<jats:italic>F<\/jats:italic>= 4\u00b75,<jats:italic>P<\/jats:italic>= 0\u00b704) contributed significantly to the variance of neuronal counts in the LC, even when covarying for gender, age of onset, cognitive impairment and cortical Alzheimer pathology. The observed disproportionate loss of noradrenergic and cholinergic neurons in the LC and basal nucleus of Meynert may represent an important organic substrate of depression in AD.<\/jats:p>","DOI":"10.1017\/s0033291700038459","type":"journal-article","created":{"date-parts":[[2009,7,9]],"date-time":"2009-07-09T10:08:21Z","timestamp":1247134101000},"page":"877-884","source":"Crossref","is-referenced-by-count":160,"title":["Clinical and neuropathological correlates of depression in Alzheimer's disease"],"prefix":"10.1017","volume":"22","author":[{"given":"Hans","family":"F\u00f6rstl","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alistair","family":"Burns","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philip","family":"Luthert","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nigel","family":"Cairns","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Lantos","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raymond","family":"Levy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2009,7,9]]},"reference":[{"key":"S0033291700038459_ref003","volume-title":"Diagnostic and Statistical Manual of Mental Disorders","year":"1987"},{"key":"S0033291700038459_ref007","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.157.1.72"},{"key":"S0033291700038459_ref051","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.1988.00520350020008"},{"key":"S0033291700038459_ref009","doi-asserted-by":"publisher","DOI":"10.1002\/cne.902870307"},{"key":"S0033291700038459_ref032","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1002\/cne.902750205","article-title":"Nucleus basalis and cortical cholinergic innervation in the human brain: observations based on the distribution of acetylcholinesterase and choline acetyltransferase","volume":"275","author":"Geula","year":"1988","journal-title":"Journal of Comparative Neurology"},{"key":"S0033291700038459_ref020","first-page":"945","article-title":"Neuropathology of the brain stem in psychiatric disorders","volume":"16","author":"Hankoff","year":"1981","journal-title":"Biological Psychiatry"},{"key":"S0033291700038459_ref049","volume-title":"Mental Disorders Glossary and Guide to their Classification in Accordance with the Ninth Revision of the International Classification of Diseases","year":"1978"},{"key":"S0033291700038459_ref047","doi-asserted-by":"publisher","DOI":"10.1097\/00005072-197909000-00004"},{"key":"S0033291700038459_ref045","doi-asserted-by":"publisher","DOI":"10.1016\/0022-510X(81)90031-9"},{"key":"S0033291700038459_ref039","doi-asserted-by":"crossref","first-page":"1017","DOI":"10.1176\/ajp.146.8.1017","article-title":"Psychopathology of very mild dementia of the Alzheimer type","volume":"146","author":"Rubin","year":"1989","journal-title":"American Journal of Psychiatry"},{"key":"S0033291700038459_ref012","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.147.5.552"},{"key":"S0033291700038459_ref036","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1176\/ajp.146.1.45","article-title":"Double-blind trial of imipramine in Alzheimer's disease patients with and without depression","volume":"146","author":"Reifter","year":"1989","journal-title":"American Journal of Psychiatry"},{"key":"S0033291700038459_ref027","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.47.2.201"},{"key":"S0033291700038459_ref034","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.1985.04060080080019"},{"key":"S0033291700038459_ref033","volume-title":"SPSS\/PC + V2.0.","author":"Norusis","year":"1988"},{"key":"S0033291700038459_ref030","first-page":"53","article-title":"Heterogeneity in dementia of the Alzheimer type: evidence of subgroups","volume":"35","author":"Mayeux","year":"1983","journal-title":"Neurology"},{"key":"S0033291700038459_ref028","doi-asserted-by":"publisher","DOI":"10.1016\/0022-510X(86)90179-6"},{"key":"S0033291700038459_ref024","first-page":"855","article-title":"Alzheimer's disease and depression: neuropsychological impairment and progression of the illness","volume":"17","author":"Lopez","year":"1990","journal-title":"American Journal of Psychiatry"},{"key":"S0033291700038459_ref023","first-page":"233","article-title":"Preliminary report on affective symptoms in the early stages of senile dementia of the Alzheimer type","volume":"10","author":"Knesevich","year":"1983","journal-title":"American Journal of Psychiatry"},{"key":"S0033291700038459_ref017","doi-asserted-by":"crossref","unstructured":"F\u00f6rstl H. , Burns A. , Luthert P. , Cairns N. & Levy R. 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