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

By Thomas J. Montine, C. Phelps, T. Beach, Eileen Bigio, Nigel J. Cairns, Dennis W. Dickson, C. Duyckaerts, Matthew P. Frosch, E. Masliah, S. Mirra and 6 more. Acta Neuropathologica, 2011

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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.

Subfields: Neurology, Physiology, Psychiatry and Mental health

View Paper: https://www.semanticscholar.org/paper/5ba85b7810528dcc681fd7653c62438fe135170f

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Citations in the corpus

International consensus classification of hippocampal sclerosis in temporal lobe epilepsy: A Task Force report from the ILAE Commission on Diagnostic Methods (2013, background): “Segmental hippocampal neuron loss can be also observed in other pathologic conditions, including dementia, aging, ischemia, and neurodegeneration, but the patterns of neuronal cell loss may differ and usually also involves the subiculum (Nelson et al., 2011; Montine et al., 2012).”
Primary age-related tauopathy (PART): a common pathology associated with human aging (2014, background): “the current guidelines for AD [64, 102], mild Aβ plaques”
The first NINDS/NIBIB consensus meeting to define neuropathological criteria for the diagnosis of chronic traumatic encephalopathy (2015, methodology): “Of the NIA-AA sampling guidelines, the following blocks are most valuable for detecting CTE: sulcal depths of the superior and middle frontal gyrus, superior and middle temporal gyrus and inferior parietal gyrus (Fig.”
Accuracy of the Clinical Diagnosis of Alzheimer Disease at National Institute on Aging Alzheimer's Disease Centers, 2005–2010 (2012, methodology): “The new NIA criteria use this same combination of NPs and Braak stage as the minimum lesion density necessary for attributing the cause of dementia to AD (39, 40).”
The neuropathological diagnosis of Alzheimer’s disease (2019, methodology): “methods that can detect Alzheimer type neuropathologic change [24], with diagnosis based upon the morphology and density of lesions and their topographic distribution.”
Alzheimer’s disease: experimental models and reality (2017, methodology): “The current consensus guidelines for neuropathological evaluation of AD are ranked on three parameters (Amyloid, Braak and CERAD staging) to obtain an “ABC” score that quantifies both neuritic plaques and NFT pathology [65, 99].”
Interpretable classification of Alzheimer’s disease pathologies with a convolutional neural network pipeline (2018, background): “Consequently, studies using limited-range scores or overall pathology burden 3,8,13,24 are powerful but have interrater variability, 4,13 are difficult to adapt to statistically meaningful disease-correlation analysis, or are blind to selected locational vulnerability 20 .”
NIA-AA Research Framework: Toward a biological definition of Alzheimer’s disease (2018, positive): “It is worthwhile emphasizing that, like the 2012 NIA-AA classification system for AD neuropathic change [105,106], AT(N) scoring of biomarkers is independent from clinical symptoms.”