Neurofibrillary tangles in human upper cervical ganglia. Morphological study with immunohistochemistry and electron microscopy.

Neurofibrillary tangles (NFTs) are one of the main pathological hallmarks of Alzheimer's disease or senile dementia, and are seen in the cerebral cortex and some other nuclei in the central nervous system (CNS). No NFTs have been reported in the human peripheral nervous system, although NFTs were recognized in the dorsal root ganglion of the aged rodents. We report here the presence of NFTs in the upper cervical ganglia (UCGs), but not in the stellate nor in the celiac ganglia, of an elderly patient, who was not demented and had only minimal senile changes in the CNS. Immunohistochemically the antibodies to microtubule-associated protein 2, paired helical filaments and ubiquitin stained positively the NFTs in the UCGs. On electron microscopic examination a periodical twisted pattern of the filaments was identified; these findings suggest that the NFTs of the UCGs have just the same properties as those of the cerebral cortex. This is the first report of the demonstration of NFTs in the peripheral ganglia and might contribute to the study of mechanism of NFT production.