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

  • Thomas J. Montine
  • Creighton H. Phelps
  • Thomas G. Beach
  • Eileen H. Bigio
  • Nigel J. Cairns
  • Dennis W. Dickson
  • Charles Duyckaerts
  • Matthew P. Frosch
  • Eliezer Masliah
  • Suzanne S. Mirra
  • Peter T. Nelson
  • Julie A. Schneider
  • Dietmar Rudolf Thal
  • John Q. Trojanowski
  • Harry V. Vinters
  • Bradley T. Hyman
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

Abstract

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

Authors and Affiliations

  • Thomas J. Montine
    • 1
  • Creighton H. Phelps
    • 2
  • Thomas G. Beach
    • 3
  • Eileen H. Bigio
    • 4
  • Nigel J. Cairns
    • 5
  • Dennis W. Dickson
    • 6
  • Charles Duyckaerts
    • 7
  • Matthew P. Frosch
    • 8
  • Eliezer Masliah
    • 9
  • Suzanne S. Mirra
    • 10
  • Peter T. Nelson
    • 11
  • Julie A. Schneider
    • 12
  • Dietmar Rudolf Thal
    • 13
  • John Q. Trojanowski
    • 14
  • Harry V. Vinters
    • 15
  • Bradley T. Hyman
    • 16
  1. 1.Department of PathologyUniversity of Washington School of MedicineSeattleUSA
  2. 2.National Institute on AgingBethesdaUSA
  3. 3.Civin Laboratory for NeuropathologyBanner Sun Health Research InstituteSun CityUSA
  4. 4.Department of Pathology and Northwestern Alzheimer Disease CenterNorthwestern University Feinberg School of MedicineChicagoUSA
  5. 5.Departments of Neurology and Pathology & ImmunologyWashington University School of MedicineSt. LouisUSA
  6. 6.Department of NeuroscienceMayo ClinicJacksonvilleUSA
  7. 7.Service de Neuropathologie Raymond EscourolleHôpital de la SalpêtriéreParisFrance
  8. 8.C.S. Kubik Laboratory for Neuropathology, Massachusetts General HospitalHarvard Medical SchoolBostonUSA
  9. 9.Departments of Neurosciences and Pathology, School of MedicineUniversity of California, San DiegoLa JollaUSA
  10. 10.Department of PathologySUNY Downstate Medical CenterBrooklynUSA
  11. 11.Sanders-Brown Center on AgingUniversity of KentuckyLexingtonUSA
  12. 12.Departments of Pathology and Neurological Sciences, Rush Alzheimer’s Disease CenterRush University Medical CenterChicagoUSA
  13. 13.Laboratory of Neuropathology, Institute of PathologyUniversity of UlmUlmGermany
  14. 14.Department of Pathology and Laboratory MedicineInstitute on Aging, Center for Neurodegenerative Disease Research, University of Pennsylvania School of MedicinePhiladelphiaUSA
  15. 15.Departments of Pathology & Laboratory Medicine (Neuropathology) and NeurologyUniversity of California Los AngelesLos AngelesUSA
  16. 16.Neurology Department, Massachusetts General HospitalHarvard UniversityBostonUSA