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Comparison of four neuropathological scales for Alzheimer's disease.

Brunnström, Hans LU and Englund, Elisabet LU (2011) In Clinical Neuropathology 30(2). p.56-69
Abstract
Objective: There are several neuropathological scales for staging of Alzheimer pathology. The system proposed by Braak and Braak is based on the topographic distribution of neurofibrillary tangles and neuropil threads, while that of the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) is based on the quantity of neocortical neuritic plaques. A combination of the Braak and CERAD staging scales was recommended by the National Institute on Aging and Reagan Institute (NIA-RI). The Poly-Pathology Alzheimer's Disease assessment, nine areas (PPAD9) is a staging system based on the extent of neuronal degeneration, microvacuolization, cytoarchitectural disorder and gliosis, in addition to neurofibrillary tangles and neuritic... (More)
Objective: There are several neuropathological scales for staging of Alzheimer pathology. The system proposed by Braak and Braak is based on the topographic distribution of neurofibrillary tangles and neuropil threads, while that of the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) is based on the quantity of neocortical neuritic plaques. A combination of the Braak and CERAD staging scales was recommended by the National Institute on Aging and Reagan Institute (NIA-RI). The Poly-Pathology Alzheimer's Disease assessment, nine areas (PPAD9) is a staging system based on the extent of neuronal degeneration, microvacuolization, cytoarchitectural disorder and gliosis, in addition to neurofibrillary tangles and neuritic plaques, in nine cerebral regions. The aim of the present study was to critically compare these four neuropathological staging scales. Methods: We assessed the Alzheimer pathology, using the four scales, in 43 patients with various dementia disorders, with focus on concordance and differences between the staging systems. Results: Comparing the staging systems, the Spearman's rho value for PPAD9 vs. Braak was 0.65, for PPAD9 vs. CERAD 0.72, for PPAD9 vs. NIA-RI 0.67, and for Braak vs. CERAD 0.46. Conclusion: The correlation between the neuropathological staging systems was suboptimal, and we conclude that the choice of staging system affects the evaluation of Alzheimer pathology, and hence the final diagnosis. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Clinical Neuropathology
volume
30
issue
2
pages
56 - 69
publisher
Dustri-Verlag
external identifiers
  • pmid:21329614
  • wos:000288625100003
  • scopus:79952414387
ISSN
0722-5091
DOI
10.5414/NPP30056
language
English
LU publication?
yes
id
3700f7c2-337a-44c5-a72c-8ae53c84e28d (old id 1831715)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/21329614?dopt=Abstract
date added to LUP
2011-03-01 17:06:46
date last changed
2017-01-01 07:54:52
@article{3700f7c2-337a-44c5-a72c-8ae53c84e28d,
  abstract     = {Objective: There are several neuropathological scales for staging of Alzheimer pathology. The system proposed by Braak and Braak is based on the topographic distribution of neurofibrillary tangles and neuropil threads, while that of the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) is based on the quantity of neocortical neuritic plaques. A combination of the Braak and CERAD staging scales was recommended by the National Institute on Aging and Reagan Institute (NIA-RI). The Poly-Pathology Alzheimer's Disease assessment, nine areas (PPAD9) is a staging system based on the extent of neuronal degeneration, microvacuolization, cytoarchitectural disorder and gliosis, in addition to neurofibrillary tangles and neuritic plaques, in nine cerebral regions. The aim of the present study was to critically compare these four neuropathological staging scales. Methods: We assessed the Alzheimer pathology, using the four scales, in 43 patients with various dementia disorders, with focus on concordance and differences between the staging systems. Results: Comparing the staging systems, the Spearman's rho value for PPAD9 vs. Braak was 0.65, for PPAD9 vs. CERAD 0.72, for PPAD9 vs. NIA-RI 0.67, and for Braak vs. CERAD 0.46. Conclusion: The correlation between the neuropathological staging systems was suboptimal, and we conclude that the choice of staging system affects the evaluation of Alzheimer pathology, and hence the final diagnosis.},
  author       = {Brunnström, Hans and Englund, Elisabet},
  issn         = {0722-5091},
  language     = {eng},
  number       = {2},
  pages        = {56--69},
  publisher    = {Dustri-Verlag},
  series       = {Clinical Neuropathology},
  title        = {Comparison of four neuropathological scales for Alzheimer's disease.},
  url          = {http://dx.doi.org/10.5414/NPP30056},
  volume       = {30},
  year         = {2011},
}