Morphological alterations of the synapses in the locus coeruleus in Parkinson's disease.

Parkinson's disease is the most common movement disorder in the broad spectrum of neurodegenerative diseases, associated frequently with gradual decline of the higher mental faculties. From the morphological point of view it is characterized by the degeneration of a substantial number of dopaminergic neurons of the substantia nigra and a considerable degeneration of neuronal networks in locus coeruleus, putamen, globus pallidus, thalamus and some areas of the cortex of the brain hemispheres. Filamentous inclusions, in the form of Lewy bodies and Lewy neuritis, composed mainly of alpha synuclein, been the hallmark of diffuse Lewy body dementia, have been described in the neurons of the substantia nigra in many cases of Parkinson's disease associated with dementia. In previous studies we have described the morphological alterations in the synapses in the caudate nucleus and the globus pallidus in cases of Parkinson's disease. In the present study we attempted to describe the morphological and morphometric alterations of the locus coeruleus in patients who suffered from Parkinson's disease with normal cognitive function and in patients who suffered from Parkinson's disease associated with dementia, comparing them with normal controls. The morphological alterations of the neurons, the dendrites, the retrograde axonic collaterals and the synapses were more impressive in cases of Parkinson's disease associated with dementia than in Parkinson's disease with normal cognitive function. The majority of the synapses demonstrated changes in size and shape of the pre- and postsynaptic components, polymorphism of the synaptic vesicles and marked morphological alterations of the mitochondria. The morphological alterations of the synapses in cases of Parkinson's disease associated with dementia, plead in favor of the importance of the neuronal circuits of locus coeruleus in cognitive functions.