Pathoanatomical Correlations Of Amyloid Plaque Distribution In Cortical And Subcortical Structures

Abstract

Amyloid plaque distribution in Alzheimer’s disease exhibits pronounced regional specificity across cortical and subcortical brain structures, reflecting underlying patterns of neural connectivity and differential tissue vulnerability. This study aimed to investigate the pathoanatomical correlations of amyloid deposition using combined macroscopic assessment, histological examination, and quantitative morphometric analysis. Cortical regions—especially temporal and parietal association areas—demonstrated the highest plaque burden, with a characteristic laminar preference for layers II–III and V–VI. Subcortical nuclei displayed heterogeneous involvement, with the basal forebrain and amygdala showing early and prominent plaque accumulation, whereas the thalamus and striatum were affected to a lesser degree. Morphometric evaluation and three-dimensional reconstruction revealed coordinated anatomical gradients consistent with trans-synaptic propagation models, highlighting the role of interconnected neural pathways in the spread of amyloid pathology. Differences in plaque morphology between cortical and subcortical regions further emphasized region-specific microenvironmental influences. These findings underscore the value of integrated pathoanatomical approaches for improving the understanding of Alzheimer’s disease progression and refining diagnostic and staging criteria.