Selective cell loss in Edinger-Westphal in asymptomatic elders and Alzheimer's patients

L. F M Scinto, M. Frosch, C. K. Wu, K. R. Daffner, N. Gedi, C. Geula

Research output: Contribution to journalArticlepeer-review

34 Scopus citations


Exaggerated pupillary response to a low concentration of cholinergic antagonists has been suggested as an early marker for Alzheimer's Disease (AD). To examine the anatomic basis of this phenomenon, we determined possible neuropathological changes in the Edinger-Westphal (EW) nucleus, a midbrain neural center with a significant functional role in the control of pupil size. Stereologically determined neuronal numbers within the EW were counted in individuals with pathologically confirmed AD, control cases with no AD-type pathology, and subjects with AD pathology not meeting diagnostic criteria for AD. The EW of AD patients displayed a marked and striking neuronal loss when compared with controls. In contrast, the number of neurons in the somatic portion of the nucleus of the third cranial nerve (NCNIII) remained intact. The EW in brains from clinically normal individuals with evidence of early AD-type pathology also displayed a significant and selective loss of neurons. The magnitude of EW neuronal loss in the latter group was smaller than that observed in AD. These findings suggest that pupillary hypersensitivity in AD may be caused by abnormalities in the EW. Neuronal loss and pathology within the EW in a subpopulation of clinically silent controls with pathologic findings consistent with early-stage AD constitutes a possible explanation for the reported exaggerated pupil response in some normal elderly subjects.

Original languageEnglish (US)
Pages (from-to)729-736
Number of pages8
JournalNeurobiology of Aging
Issue number5
StatePublished - Nov 24 2001


  • Alzheimer disease
  • Edinger-Westphal nucleus
  • Immunohistochemistry
  • Neuronal loss
  • Pupillary reflex
  • Stereology
  • Tangles

ASJC Scopus subject areas

  • Neuroscience(all)
  • Aging
  • Clinical Neurology
  • Developmental Biology
  • Geriatrics and Gerontology

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