National Institute on Aging–Alzheimer’s Association guidelines for the neuropathologic assessment of Alzheimer’s disease: a practical approach

Springer Science and Business Media LLC - Tập 123 - Trang 1-11 - 2011
Thomas J. Montine1, Creighton H. Phelps2, Thomas G. Beach3, Eileen H. Bigio4, Nigel J. Cairns5, Dennis W. Dickson6, Charles Duyckaerts7, Matthew P. Frosch8, Eliezer Masliah9, Suzanne S. Mirra10, Peter T. Nelson11, Julie A. Schneider12, Dietmar Rudolf Thal13, John Q. Trojanowski14, Harry V. Vinters15, Bradley T. Hyman16
1Department of Pathology, University of Washington School of Medicine, Seattle, USA
2National Institute on Aging, Bethesda, USA
3Civin Laboratory for Neuropathology, Banner Sun Health Research Institute, Sun City, USA
4Department of Pathology and Northwestern Alzheimer Disease Center, Northwestern University Feinberg School of Medicine, Chicago, USA
5Departments of Neurology and Pathology & Immunology, Washington University School of Medicine, St. Louis, USA
6Department of Neuroscience, Mayo Clinic, Jacksonville, USA
7Service de Neuropathologie Raymond Escourolle, Hôpital de la Salpêtriére, Paris, France
8C.S. Kubik Laboratory for Neuropathology, Massachusetts General Hospital, Harvard Medical School, Boston, USA
9Departments of Neurosciences and Pathology, School of Medicine, University of California, San Diego, La Jolla, USA
10Department of Pathology, SUNY Downstate Medical Center, Brooklyn, USA.
11Sanders-Brown Center on Aging, University of Kentucky, Lexington, USA
12Departments of Pathology and Neurological Sciences, Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, USA
13Laboratory of Neuropathology, Institute of Pathology, University of Ulm, Ulm, Germany
14Department of Pathology and Laboratory Medicine, Institute on Aging, Center for Neurodegenerative Disease Research, University of Pennsylvania School of Medicine, Philadelphia, USA
15Departments of Pathology & Laboratory Medicine (Neuropathology) and Neurology, University of California Los Angeles, Los Angeles, USA
16Neurology Department, Massachusetts General Hospital, Harvard University, Boston, USA

Tóm tắt

We present a practical guide for the implementation of recently revised National Institute on Aging–Alzheimer’s Association guidelines for the neuropathologic assessment of Alzheimer’s disease (AD). Major revisions from previous consensus criteria are: (1) recognition that AD neuropathologic changes may occur in the apparent absence of cognitive impairment, (2) an “ABC” score for AD neuropathologic change that incorporates histopathologic assessments of amyloid β deposits (A), staging of neurofibrillary tangles (B), and scoring of neuritic plaques (C), and (3) more detailed approaches for assessing commonly co-morbid conditions such as Lewy body disease, vascular brain injury, hippocampal sclerosis, and TAR DNA binding protein (TDP)-43 immunoreactive inclusions. Recommendations also are made for the minimum sampling of brain, preferred staining methods with acceptable alternatives, reporting of results, and clinico-pathologic correlations.

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