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April 1984

Alzheimer's Disease: A Single Entity?-Reply

Author Affiliations

ACOS/Research and Development Veterans Administration Hospital Bedford, MA 01730

Arch Neurol. 1984;41(4):362-363. doi:10.1001/archneur.1984.04050160024006

In Reply.  —It is important to note at the outset that Dr Segarra takes no exception to the findings presented in our article: as a group, patients with early-onset but not those with lateonset primary degenerative dementia of the Alzheimer type show a high prevalence of language disorders, left-handedness, and reduced longevity. Instead, his comments represent an alternative interpretation.In attempting to reinterpret our data, Segarra suggests that we "assume Alzheimer's disease is a diffuse global process affecting both hemispheres about equally." To a classic neuropathologist accustomed to looking at the brains of patients at the end stage of their illness, this assumption might appear reasonable. However, we are unaware of any process that, over its course, affects the brain in a totally global and diffuse manner. More specifically, new evidence from studies of the nucleus basalis of Meynert1 and studies involving regional levels of choline acetyltransferase2 has indicated

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