Comparison of two quantitative methods for the evaluation of neuronal number in the frontal cortex in Alzheimer disease.

How to assess the substantial neuronal loss in a neurodegenerative disease such as Alzheimer disease is still being debated. Recently, stereological procedures have been proposed that claim improved accuracy and statistical power, but the results of some of these investigations have been controversial. In this study we compared and correlated the cell density results calculated per unit of volume obtained by a stereological technique, the "selector," with the cell counts per unit area obtained by computer-aided image analysis morphometry, in the same sections of midfrontal cortex in Alzheimer disease and control cases. The "selector" revealed a significant decrease in neuronal density that correlated well with a similar fall in large neuronal counts per unit area, as estimated by image analysis morphometry. These results indicate that stereological techniques and image analysis morphometry are complementary methods in reliably assessing cellular populations in neurodegenerative disorders.