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Brain Pathol. 2008 Oct;18(4):484-96. doi: 10.1111/j.1750-3639.2008.00147.x. Epub 2008 Mar 26.

Staging of neurofibrillary pathology in Alzheimer's disease: a study of the BrainNet Europe Consortium.

Author information

1
Department of Neuroscience and Neurology, Kuopio University, Kuopio, Finland. Irina.Alafuzoff@uku.fi

Abstract

It has been recognized that molecular classifications will form the basis for neuropathological diagnostic work in the future. Consequently, in order to reach a diagnosis of Alzheimer's disease (AD), the presence of hyperphosphorylated tau (HP-tau) and beta-amyloid protein in brain tissue must be unequivocal. In addition, the stepwise progression of pathology needs to be assessed. This paper deals exclusively with the regional assessment of AD-related HP-tau pathology. The objective was to provide straightforward instructions to aid in the assessment of AD-related immunohistochemically (IHC) detected HP-tau pathology and to test the concordance of assessments made by 25 independent evaluators. The assessment of progression in 7-microm-thick sections was based on assessment of IHC labeled HP-tau immunoreactive neuropil threads (NTs). Our results indicate that good agreement can be reached when the lesions are substantial, i.e., the lesions have reached isocortical structures (stage V-VI absolute agreement 91%), whereas when only mild subtle lesions were present the agreement was poorer (I-II absolute agreement 50%). Thus, in a research setting when the extent of lesions is mild, it is strongly recommended that the assessment of lesions should be carried out by at least two independent observers.

PMID:
18371174
PMCID:
PMC2659377
DOI:
10.1111/j.1750-3639.2008.00147.x
[Indexed for MEDLINE]
Free PMC Article

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