Article Text

  1. J. R. Wallace,
  2. H. V. Vinters
  1. Department of Pathology and Laboratory Medicine, Division of Neuropathology, David Geffen School of Medicine at UCLA, Los Angeles, CA


The brains of patients who die with Alzheimer's disease demonstrate characteristic microscopic as well as macroscopic abnormalities; brain autopsy includes assessment of both types of abnormality. Microscopically, intraneuronal neurofibrillary changes and extracellular β-amyloid deposition can be revealed by immunohistochemistry performed on brain tissue. Visualization, while subjective, allows an experienced pathologist to assess macroscopic changes such as brain atrophy and ventricular enlargement. These changes, while associated with Alzheimer's disease, may also be seen in normal aging, the difference being the extent and distribution of the changes. In this study, 155 autopsy protocols of patients diagnosed with Alzheimer's disease were reviewed. Three gross parameters—degree of cortical atrophy, degree of ventriculomegaly, and fresh brain weight—were examined as a function of AD severity, as well as correlated to the microscopic progression of AD as determined by Braak staging. It has long been assumed that the microscopic progression of AD is paralleled by concomitant brain atrophy and ventricular enlargement. The findings of this study confirm this hypothesis of association.

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