Hippocampal Pathology Reflects Memory Deficit and Brain Imaging Measurements in Alzheimers Disease: Clinicopathologic Correlations Using Three Sets of Pathologic Diagnostic Criteria

Abstract

Neurofibrillary tangles (NFT), neuritic plaques and amyloid load were quantified in sections of the hippocampus at the level of the lateral geniculate body in 41 consecutive cases fulfilling pathological criteria for diagnosis of Alzheimer’s disease (AD) and coming to autopsy after longitudinal study during life. A strong correlation was found between NFT density in the hippocampus and cognitive impairment scores obtained shortly before death, particularly with scores of memory impairment. Weaker and less consistent correlations were found for hippocampal neuritic plaques and amyloid load with cognitive/ memory deficits. No significant correlations were found between hippocampal pathology and either age of onset or disease duration. All three measures of hippocampal pathology were inversely correlated with the minimum medial temporal lobe (MTL) width, a measure of the MTL atrophy made from temporal-lobe-oriented X-ray computed tomography scans performed during life; the strongest correlation being between atrophy of the MTL and NFT density in the hippocampus.

Magnetic resonance imaging differences between dementia with Lewy bodies and Alzheimer's disease: a pilot study

“…This requires confirmation in a larger series, though if confirmed MRI may have a role in identifying in vivo DLB subjects with concurrent Alzheimer pathology. In support of this, both Huesgen et al (1993) and Nagy et al (1996) found a strong correlation between temporal lobe volume loss on MRI and tangle count at post-mortem. It is also interesting that we found a significant correlation between MMSE score and temporal lobe volume in the AD but not the DLB group.…”

β‐amyloid burden is not associated with rates of brain atrophy

“…9 Other studies have also found significant correlations between neurofibrillary tangle burden or Braak NFT stage and measurements of regional hippocampal volumes or medial temporal lobe width in subjects with AD. [44][45][46] One other previous study has also found a stronger association between the degree of brain loss and neurofibrillary tangle burden than between the degree of brain loss and Aβ burden. 44 An association was also observed between rates of brain loss and age at the time of scan in the whole group, with the rate of both brain volume loss and ventricular expansion decreasing as the average age increases.…”

Diagnosing Dementia: Interrater Reliability Assessment and Accuracy of the NINCDS/ADRDA Criteria versus CERAD Histopathological Criteria for Alzheimer’s Disease

“…This reflects the nature of the CERAD criteria, which are based on semi-quantified assessment of the density of histological changes, but also depend upon the absence or presence of a clinical diagnosis of dementia. Nagy et al [9,19] found that the use of quantified histopathological data (by counting the number of diffuse plaques and neurofibrillary tangles/mm 2 ) without the use of clinical information could result in a more accurate differentiation between AD, other types of dementia, and controls. Patients diagnosed as NINCDS/ ADRDA 'possible' or 'probable' AD were found to have a significantly higher quantified amyloid load, neuritic plaque and neurofibrillary tangle density compared to patients suffering from dementias other than AD or controls.…”