Aluminum accumulation in tangle-bearing neurons of Alzheimer's disease with Balint's syndrome in a long-term aluminum refiner

Abstract

Progressive dementia had developed since the age of 55 in a male patient, who had worked as an aluminum refiner for 30 years. Balint's syndrome was observed from at 60 and he died of bronchopneumonia at 65. Neuropathological examination revealed characteristic features of Alzheimer's disease with marked atrophy of the occipito-temporal lobes and senile plaques of the cerebellum. Wavelength-dispersive X-ray microanalysis disclosed focal aluminum accumulation within the nucleus and cytoplasm of the tangle-bearing neurons. Microanalysis by the same method failed to disclose aluminum accumulation in the tangle-bearing neurons in a case of senile dementia of Alzheimer's type who had no possible inhalation of aluminum.

Posterior Cortical Atrophy: Clinical Characteristics and Differences Compared to Alzheimer’s Disease

“…In most autopsied cases of PCA, the usual temporoparietal pathology of AD is present in the occipitoparietal and posterior temporal regions [2,4,8,12,14,34,42,[47][48][49]. Compared to typical AD, the visual association areas are heavily affected and the frontal regions are spared [48].…”

“…In addition, relative sparing of mesiotemporal regions may explain the better memory, but poorer response to acetylcholinesterase inhibitors, in the PCA group compared to the typical AD group. The reason for this posterior shift of AD is unclear, but, at least in one instance, it has occurred after heavy and sustained exposure to aluminum [49]. Another potential cause of a rapid PCA syndrome is the visual or 'Heidenhain variant' of Creutzfeldt-Jakob disease [9,50], and, in a few patients, PCA has proven to be subcortical gliosis or a familial illness [2,41].…”

Cognitive Deterioration and Associated Pathology Induced by Chronic Low-Level Aluminum Ingestion in a Translational Rat Model Provides an Explanation of Alzheimer's Disease, Tests for Susceptibility and Avenues for Treatment

“…Al causes dialysis encephalopathy [91], a dementia that is generally fatal unless the affected renal patients are treated and controlled with Al chelation [92]. Al has also been implicated in dementias associated with occupational Al exposure, including Balint's syndrome [93] and in the amyotrophic lateral sclerosis with parkinsonism dementia of Guam (ALS/PD) [94]. Al caused cognitive impairment in Canadian miners who inhaled Macintyre powder (pulverized Al and Al hydroxide) over an extended time to avoid lung silicosis [95].…”

A glutamatergic mechanism for aluminum toxicity in astrocytes

“…The most extensive studies have focused on Alzheimer disease; however, the results of these studies have been contradictory. Some investigators reported elevated aluminum in both bulk brain tissues (Trapp et al, 1978;McLachlan et al, 1989) and in neurofibrillary tangles (Perl and Brody, 1980a,b;Perl et al, 1982;Perl and Pendlebury, 1984), but others reported normal aluminum levels in both bulk tissues (McDermott et a!., 1979;Markesbery et a!., 1981Markesbery et a!., , 1983Jacobs et a!., 1989) and in senile plaques (Kobayashi et al, 1987). Some pathological findings in patients with Alzheimer disease have been interpreted as being consistent with damage to glutamatergic neurons (Maragos et al, 1978;Greenamyre and Young, 1989).…”