Atrophy of the cerebellar vermis in ageing. A morphometric and histologic study.

Morphometric analysis of the cerebellar vermis in 67 non-alcoholic men between 36 and 94 years of age showed a significant decline in Purkinje cell densities with increasing age in all parts of the cerebellar vermis. However, the nerve cell loss was much more severe in the superior than in the inferior part. There were large individual variations and one-half of the subjects over 80 years showed densities similar to those in the sixties. By independent evaluation, atrophy of the superior vermis was diagnosed histologically in 16 cases, 13 of whom were over 70 years of age. There was a good correspondence between the histologic diagnoses and the morphometric findings. The atrophy involved all 3 cortical layers and the changes were identical to those seen in alcoholics. The diagnosis of alcoholic cerebellar atrophy must therefore be made with great caution in subjects over 70 years of age. Cases with malignant tumours had significantly lower Purkinje cell densities in the superior vermis than those without tumours but the decline with age was of the same magnitude in the 2 groups. The age-dependent atrophy of the superior vermis seemed to be correlated to age alone and not to other known conditions. It probably was sufficiently severe to be recognized radiologically and clinically in a considerable number of the cases.