Pakkenberg · Journal of neurology, neurosurgery, and psychiatry 1991 · Post-mortem case-control stereological study · n=14

The absolute number of nerve cells in substantia nigra in normal subjects and in patients with Parkinson's disease estimated with an unbiased stereological method.

Cited 406 times in the scientific literature.

Level 4 - case-series / case-control

Post-mortem case-control study

PubMed 2010756 · doi:10.1136/jnnp.54.1.30 · record verified 2026-08-26

What was done

Total numbers of pigmented and non-pigmented neurons in the substantia nigra were estimated post-mortem in 7 patients with Parkinson's disease and 7 control subjects using an unbiased stereological counting method independent of nerve cell size, section thickness, and tissue shrinkage.

What was found

In controls, the average total number of pigmented neurons was 550,000 and non-pigmented neurons was 260,000. In Parkinson's disease patients, pigmented neurons were reduced by 66% and non-pigmented neurons were reduced by 24%. A significant correlation was observed between pigmented and non-pigmented neuron totals in controls (r = 0.81), whereas the correlation in patients (r = 0.72) fell just short of statistical significance.

Why it matters

This study provides precise, unbiased stereological estimates of absolute neuronal loss in the substantia nigra in Parkinson's disease, showing that neurodegeneration affects both pigmented and non-pigmented neuronal populations.

Limits

The sample size was very small (7 patients and 7 controls). The abstract does not report patient age, disease duration, clinical severity, post-mortem intervals, or medication exposure.

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