Common senile degeneration and degenerative diseases of senility and pre-senility of the brain: a perspective.

This report is concerned with advances in the study of common senile brain degeneration and of its relationship with degenerative diseases of the brain in senility and pre-senility. In 1968, the principal topic of discussion at the 52nd Congress of the German Society of Pathology in Wiirzburg was the study of the senile brain, and presentations included reports by Colmant.’ Gerhard,* Jellinger,3 Peiffer,” Quadbeck,-i Seitelberger.” Thomas,’ and Ule.s A review concerning the senile brain by Giampalmo et al,’ which considered the changes in the meninges, vessels, choroid plexuses, and brain parenchyma, appeared in 198 1 and was updated in 1985. During the past 2 years, the most important developments in this area have concerned both the abnormalities of neuronal function and the structural changes, in particular those of Alzheimer’s disease, Pick’s disease, and Parkinson’s disease. The changes in the brain parenchyma secondary to arteriosclerosis are summarized in Table 1, which is partly derived from our previous work.” Specific degenerative diseases of senility and presenility pertain to Gowers’ abiotrophic changes,‘* and correspond to Spielmeyer’s primary degenerations,’ ’ Spatz’s systemic atrophies,‘” and to the report of topistic degenerations by Vogt and VogtrS based on the concept of Pathoklise later developed by Seitelberger.” These definitions are substantially interchangeable, and reflect the progression of knowledge in neuropathology. Research concerning the degenerative changes of the CNS has shifted from the morphologic approach of Ramon y Cajal,‘+ Golgi,‘j Streeter,‘” Filimonov, l7 Yakovlev and Lecours,ls and Sidman and Rakic’” to a functional, dynamic approach. The development of anatomy and physiology