Four new monoclonal antibodies to the extracellular domain of the nerve growth factor receptor (NGFR) have been evaluated for their specificity to NGFR and their utility in localizing NGFR in human brain. All four antibodies, as well as Me20.4, show similar cellular localization and patterns of immunoreactivity in basal forebrain neurons. NGFR monoclonal antibody XIF1 stains optimally over the widest range of concentrations, with staining being reduced only slightly at less than 10 pg/ml or more than 100 ng/ml, and produces the lowest background of those tested. Staining with all NGFR monoclonal antibodies is blocked by the addition of as little as 5-fold excess human recombinant truncated NGFR protein. The distribution of NGFR-containing neurons is similar to that previously described in normal human forebrain, as is the reduction in cell size in nucleus basalis (Ch4am) in brains from patients with Alzheimer's disease. In addition, we find evidence in the two Alzheimer's cases examined for a previously unreported loss of cells in the horizontal limb nucleus of the diagonal band (Ch3) in Alzheimer's disease. The loss of these neurons, which in normal brain have characteristic varicose dendritic processes extending to the pial surface adjacent to the cisternal space, may indicate a change in the relationship of NGF-sensitive neurons to the vasculature. Since these neurons project to olfactory bulb and cortex in rodent and primate brains, their loss may also reflect damage to the olfactory system in Alzheimer's disease.