The human locus coeruleus in neurology and psychiatry: Parkinson's, Lewy body, Hallervorden-Spatz, Alzheimer's and Korsakoff's disease, (pre)senile dementia, schizophrenia, affective disorders, psychosis

Abstract

1. 1. The locus coeruleus (LC) is quantitatively the most important noradrenergic (NE) nucleus in the brain. The LC and the central NE transmission appear to be disturbed in the following diseases: idiopathic and post-encephalitic Parkinson's disease, Hallervorden-Spatz disease, Alzheimer's disease, paranoid schizophrenia and endogenous “NE depression” (i.e. a form of endogenous depression characterized by low levels of urinary MHPG). 2. 2. In the brains of idiopathic Parkinsonian and Hallervorden-Spatz patients, Lewy bodies and cell loss in the LC are present. The Parkinsonian motor symptoms are probably not caused by dysfunctions of the LC. 3. 3. The LC of patients with postencephalitic Parkinson's or Alzheimer's disease shows neurofibrillary tangles and cell loss. 4. 4. In paranoid schizophrenia, the brain NE content is increased; such increase has been found in terminal regions of the LC and others. 5. 5. In endogenous NE depression, the NE levels in some LC target regions are reduced; it is suggested that hypertrophy of central adrenoceptors (“supersensitivity”) is a cause of endogenous NE depression. 6. 6. The involvement of the LC and the central NE transmission in the following diseases is less certain: Korsakoff's disease, progressive supranuclear palsy, epilepsy, anxiety states, and other forms of schizophrenia and affective disorders than paranoia and endogenous “NE-depression”. 7. 7. The following symptoms are often found in diseases with disturbances in the LC and the central NE transmission: impairments of perceptual organization and memory, disorientation, confusions, delusions and hallucinations. It is suggested that dysfunctions of the LC are a cause of these symptoms. This suggestion is in line with conclusions on the LC's “function” from animal studies. 8. 8. Changes in mood (depression) and personality have been found in endogenous NE depression, and in Parkinson's and Alzheimer's disease. These symptoms might be caused by disturbances in the LC and the central NE transmission.