In this case of Alzheimer's disease, there is more marked atrophy seen superiorly and laterally, with sparing of the occipital region.

Which of the following enzymes is most critical to formation of neuritic plaques and subsequent cerebral atrophy with Alzheimer disease?

A Acetylcholinesterase

B Alpha-L-iduronidase

C Beta-N-acetylhexosaminidase A

D Secretase

E Sphingomyelinase