Neuropathological stageing of Alzheimer-related changes

Abstract

Eighty-three brains obtained at autopsy from nondemented and demented individuals were examined for extracellular amyloid deposits and intraneuronal neurofibrillary changes. The distribution pattern and packing density of amyloid deposits turned out to be of limited significance for differentiation of neuropathological stages. Neurofibrillary changes occurred in the form of neuritic plaques, neurofibrillary tangles and neuropil threads. The distribution of neuritic plaques varied widely not only within architectonic units but also from one individual to another. Neurofibrillary tangles and neuropil threads, in contrast, exhibited a characteristic distribution pattern permitting the differentiation of six stages. The first two stages were characterized by an either mild or severe alteration of the transentorhinal layer Pre-alpha (transentorhinal stages I-II). The two forms of limbic stages (stages III-IV) were marked by a conspicuous affection of layer Pre-alpha in both transentorhinal region and proper entorhinal cortex. In addition, there was mild involvement of the first Ammon's horn sector. The hallmark of the two isocortical stages (stages V-VI) was the destruction of virtually all isocortical association areas. The investigation showed that recognition of the six stages required qualitative evaluation of only a few key preparations.

Intracellular domains of amyloid precursor-like protein 2 interact with CP2 transcription factor in the nucleus and induce glycogen synthase kinase-3β expression

“…A neuropathological diagnosis of AD was confirmed according to the criteria of Braak. 25 Blocks of AD or control tissue were fixed in 10% neutral buffered formalin for 48 h. After fixation, the brain tissue was dehydrated and embedded in paraffin. Immunohistochemistry was performed using a Vectastain avidin-biotin complex (ABC) elite kit (Vector, Burlingame, CA, USA) as described previously.…”

Albuminuria Increases the Risks for Both Alzheimer Disease and Vascular Dementia in Community‐Dwelling Japanese Elderly: The Hisayama Study

“…Each of the specimens was cut into 8‐ to 15‐mm sections except for the brainstem, which was cut into 5‐mm sections, and the microinfarcts and bleeding were carefully evaluated in each section. A neuropathologic diagnosis of AD was made following the National Institute on Aging―Reagan Institute criteria21; the frequencies of neuritic plaques and neurofibrillary tangles were evaluated using the Consortium to Establish a Registry for Alzheimer's Disease criteria22 and Braak stage 23. Definite VaD cases were confirmed with causative stroke or cerebrovascular change and no neuropathologic evidence of other forms of dementia.…”

Clinicopathological and 123I‐FP‐CIT SPECT correlations in patients with dementia

“…Neuropathologic diagnosis was made using previously published neuropathologic criteria, including Braak stages,18, 19 Consortium to Establish a Registry for Alzheimer's Disease scores,19, 20 Thal A β phases,19, 21 LBD pathologic criteria,11 and FTLD classification22 by neuropathologists who were blinded to the 123 I‐FP‐CIT SPECT findings.…”