Neuropathologic Criteria for Diagnosing Alzheimer Disease in Persons with Pure Dementia of Alzheimer Type
| Autor: | Joseph L. Price, Leonard Berg, John C. Morris, Daniel W. McKeel, Elizabeth A. Grant, J. Philip Miller, Chengjie Xiong |
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| Rok vydání: | 2004 |
| Předmět: |
Adult
Male Pathology medicine.medical_specialty Clinical Dementia Rating Plaque Amyloid Neuropathology Sensitivity and Specificity Pathology and Forensic Medicine Central nervous system disease Cellular and Molecular Neuroscience Alzheimer Disease Cadaver medicine Humans Dementia Senile plaques Aged Aged 80 and over Brain Neurofibrillary Tangles Neurofibrillary tangle General Medicine Middle Aged medicine.disease Entorhinal cortex ROC Curve Neurology Area Under Curve Case-Control Studies Female Neurology (clinical) Alzheimer's disease Psychology |
| Zdroj: | Journal of Neuropathology & Experimental Neurology. 63:1028-1037 |
| ISSN: | 1554-6578 0022-3069 |
| DOI: | 10.1093/jnen/63.10.1028 |
| Popis: | Universally accepted neuropathologic criteria for differentiating Alzheimer disease (AD) from healthy brain aging do not exist. We tested the hypothesis that Bielschowsky silver stained total, cored, and neuritic senile plaques (TSPs, CSPs, and NSPs, respectively), rather than neurofibrillary tangles (NFTs), best discriminate between the 2 conditions using rigorously defined nondemented (n = 7) and AD (n = 35) subjects with no known co-morbidities. We compared lesions in 3 neocortical regions, in hippocampal CA1, and in entorhinal cortex in 19 men and 13 women between 74 and 86 years at death. The Clinical Dementia Rating (CDR) was used to assess degree of cognitive impairment within a year of demise. Neocortical TSP measures provided the highest correlation with expiration CDR: area under the curve (AUC) = 0.986 with 97.8% sensitivity at 90% specificity with an estimated cut-point of 6.0 TSP/ mm2. All SP measures yielded higher estimated AUC and sensitivity for 90% specificity compared to NFTs. Derived TSP cut-points applied to 149 persons with clinical AD regardless of their neuropathologic diagnosis yielded a sensitivity of 97% and specificity of 84% for TSPs in the 3 neocortical areas. Thus cut-points based on both diffuse and neuritic SP in neocortical regions distinguished nondemented and AD subjects with high sensitivity and specificity. |
| Databáze: | OpenAIRE |
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