Acta Neuropathologica

, Volume 128, Issue 6, pp 755–766

Primary age-related tauopathy (PART): a common pathology associated with human aging

Authors

    • Department of Pathology and Cell Biology and the Taub Institute for Research on Alzheimer’s Disease and the Aging BrainColumbia University Medical Center
  • John Q. Trojanowski
    • Department of Pathology, Division of NeuropathologyUniversity of Pennsylvania
  • Julie A. Schneider
    • Departments of Pathology (Neuropathology) and Neurological SciencesRush University Medical Center
  • Jose F. Abisambra
    • Department of Physiology and Sanders-Brown Center on AgingUniversity of Kentucky
  • Erin L. Abner
    • Department of Public Health and Sanders-Brown Center on AgingUniversity of Kentucky
  • Irina Alafuzoff
    • Department of Immunology, Genetics and PathologyUppsala University
  • Steven E. Arnold
    • Departments of Psychiatry and NeurologyUniversity of Pennsylvania
  • Johannes Attems
    • Institute for Ageing and Health, Newcastle University
  • Thomas G. Beach
    • Civin Laboratory for NeuropathologyBanner Sun Health Research Institute
  • Eileen H. Bigio
    • Department of Pathology (Neuropathology), Northwestern Cognitive Neurology and Alzheimer Disease CenterNorthwestern University Feinberg School of Medicine
  • Nigel J. Cairns
    • Department of Pathology and ImmunologyWashington University School of Medicine
  • Dennis W. Dickson
    • Department of NeuroscienceMayo Clinic
  • Marla Gearing
    • Department of Pathology and Laboratory Medicine (Neuropathology)Emory University School of Medicine
  • Lea T. Grinberg
    • Departments of Neurology and PathologyUC
    • Department of PathologyUniversity of Sao Paulo
  • Patrick R. Hof
    • Fishberg Department of Neuroscience and Friedman Brain InstituteIcahn School of Medicine at Mount Sinai
  • Bradley T. Hyman
    • Department of NeurologyHarvard Medical School and Massachusetts General Hospital
  • Kurt Jellinger
    • Institute of Clinical Neurobiology
  • Gregory A. Jicha
    • Department of Neurology and the Sanders-Brown Center on AgingUniversity of Kentucky
  • Gabor G. Kovacs
    • Institute of Neurology, Medical University Vienna
  • David S. Knopman
    • Department of NeurologyMayo Clinic
  • Julia Kofler
    • Department of Pathology (Neuropathology)University of Pittsburgh Medical Center
  • Walter A. Kukull
    • Department of EpidemiologyUniversity of Washington
  • Ian R. Mackenzie
    • Department of PathologyUniversity of British Columbia
  • Eliezer Masliah
    • Departments of Neurosciences and PathologyUniversity of California
  • Ann McKee
    • Department of Pathology (Neuropathology)Boston University
  • Thomas J. Montine
    • Department of PathologyUniversity of Washington
  • Melissa E. Murray
    • Department of NeuroscienceMayo Clinic
  • Janna H. Neltner
    • Department of PathologyUniversity of Kentucky
  • Ismael Santa-Maria
    • Department of Pathology and Cell Biology and the Taub Institute for Research on Alzheimer’s Disease and the Aging BrainColumbia University Medical Center
  • William W. Seeley
    • Departments of Neurology and PathologyUniversity of California
  • Alberto Serrano-Pozo
    • Department of NeurologyUniversity of Iowa Hospitals and Clinics
  • Michael L. Shelanski
    • Department of Pathology and Cell Biology and the Taub Institute for Research on Alzheimer’s Disease and the Aging BrainColumbia University Medical Center
  • Thor Stein
    • Department of Pathology (Neuropathology)VA Medical Center and Boston University School of Medicine
  • Masaki Takao
    • Department of NeuropathologyTokyo Metropolitan Geriatric Hospital
  • Dietmar R. Thal
    • Laboratory of NeuropathologyUniversity of Ulm
  • Jonathan B. Toledo
    • Department of Pathology, Division of NeuropathologyUniversity of Pennsylvania
  • Juan C. Troncoso
    • Department of Pathology and Laboratory MedicineInstitute on Aging, Center for Neurodegenerative Disease Research, University of Pennsylvania Perelman School of Medicine
  • Jean Paul Vonsattel
    • Department of Pathology and Cell Biology and the Taub Institute for Research on Alzheimer’s Disease and the Aging BrainColumbia University Medical Center
  • Charles L. White3rd
    • Department of Pathology (Neuropathology)University of Texas Southwestern Medical School
  • Thomas Wisniewski
    • Departments of Neurology, Pathology and PsychiatryNew York University School of Medicine
  • Randall L. Woltjer
    • Department of Pathology L113Oregon Health Sciences University
  • Masahito Yamada
    • Departments of Neurology & Neurobiology of AgingKanazawa University Graduate School of Medical Sciences
    • Department of Pathology (Neuropathology) and Sanders-Brown Center on AgingUniversity of Kentucky
Consensus Paper

DOI: 10.1007/s00401-014-1349-0

Cite this article as:
Crary, J.F., Trojanowski, J.Q., Schneider, J.A. et al. Acta Neuropathol (2014) 128: 755. doi:10.1007/s00401-014-1349-0

Abstract

We recommend a new term, “primary age-related tauopathy” (PART), to describe a pathology that is commonly observed in the brains of aged individuals. Many autopsy studies have reported brains with neurofibrillary tangles (NFTs) that are indistinguishable from those of Alzheimer’s disease (AD), in the absence of amyloid (Aβ) plaques. For these “NFT+/Aβ−” brains, for which formal criteria for AD neuropathologic changes are not met, the NFTs are mostly restricted to structures in the medial temporal lobe, basal forebrain, brainstem, and olfactory areas (bulb and cortex). Symptoms in persons with PART usually range from normal to amnestic cognitive changes, with only a minority exhibiting profound impairment. Because cognitive impairment is often mild, existing clinicopathologic designations, such as “tangle-only dementia” and “tangle-predominant senile dementia”, are imprecise and not appropriate for most subjects. PART is almost universally detectable at autopsy among elderly individuals, yet this pathological process cannot be specifically identified pre-mortem at the present time. Improved biomarkers and tau imaging may enable diagnosis of PART in clinical settings in the future. Indeed, recent studies have identified a common biomarker profile consisting of temporal lobe atrophy and tauopathy without evidence of Aβ accumulation. For both researchers and clinicians, a revised nomenclature will raise awareness of this extremely common pathologic change while providing a conceptual foundation for future studies. Prior reports that have elucidated features of the pathologic entity we refer to as PART are discussed, and working neuropathological diagnostic criteria are proposed.

Keywords

TPSDTODBraakNeuropathologyConsensus

Copyright information

© Springer-Verlag Berlin Heidelberg 2014