Acta Neuropathologica

, Volume 123, Issue 1, pp 1–11

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


    • Department of PathologyUniversity of Washington School of Medicine
  • Creighton H. Phelps
    • National Institute on Aging
  • Thomas G. Beach
    • Civin Laboratory for NeuropathologyBanner Sun Health Research Institute
  • Eileen H. Bigio
    • Department of Pathology and Northwestern Alzheimer Disease CenterNorthwestern University Feinberg School of Medicine
  • Nigel J. Cairns
    • Departments of Neurology and Pathology & ImmunologyWashington University School of Medicine
  • Dennis W. Dickson
    • Department of NeuroscienceMayo Clinic
  • Charles Duyckaerts
    • Service de Neuropathologie Raymond EscourolleHôpital de la Salpêtriére
  • Matthew P. Frosch
    • C.S. Kubik Laboratory for Neuropathology, Massachusetts General HospitalHarvard Medical School
  • Eliezer Masliah
    • Departments of Neurosciences and Pathology, School of MedicineUniversity of California, San Diego
  • Suzanne S. Mirra
    • Department of PathologySUNY Downstate Medical Center
  • Peter T. Nelson
    • Sanders-Brown Center on AgingUniversity of Kentucky
  • Julie A. Schneider
    • Departments of Pathology and Neurological Sciences, Rush Alzheimer’s Disease CenterRush University Medical Center
  • Dietmar Rudolf Thal
    • Laboratory of Neuropathology, Institute of PathologyUniversity of Ulm
  • John Q. Trojanowski
    • Department of Pathology and Laboratory MedicineInstitute on Aging, Center for Neurodegenerative Disease Research, University of Pennsylvania School of Medicine
  • Harry V. Vinters
    • Departments of Pathology & Laboratory Medicine (Neuropathology) and NeurologyUniversity of California Los Angeles
  • Bradley T. Hyman
    • Neurology Department, Massachusetts General HospitalHarvard University
Consensus Paper

DOI: 10.1007/s00401-011-0910-3

Cite this article as:
Montine, T.J., Phelps, C.H., Beach, T.G. et al. Acta Neuropathol (2012) 123: 1. doi:10.1007/s00401-011-0910-3


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.

Copyright information

© Springer-Verlag 2011