Application of the National Institute on Aging (NIA)-Reagan Institute criteria for the neuropathological diagnosis of Alzheimer disease
Application of the National Institute on Aging (NIA)-Reagan Institute criteria for the neuropathological diagnosis of Alzheimer disease
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DOI：
10.1097/00005072-199911000-00004
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发表时间：
1999-11-01
影响因子：
3.2
通讯作者：
Hedley-Whyte, ET
中科院分区：
文献类型：
--
作者：
Newell, KL;Hyman, BT;Hedley-Whyte, ET
哈achaturian标准和建立阿尔茨海默病登记协会（CERAD）阿尔茨海默病（AD）的神经病理学评估标准强调：神经斑块、年龄和临床病史。美国国家衰老研究所(NIA)-里根研究所共识会议提出了一种新的方案，强调神经原纤维变化的地形分期和神经性斑块。该方案将痴呆症由阿尔茨海默氏症引起的可能性分为高、中、低三类。我们将该方法应用于84个大脑，这些大脑来自临床和神经病理学诊断为AD (n = 33)，非AD痴呆（n = 34），包括路易体痴呆（DLB）和进行性核上性麻痹（PSP），以及无神经系统疾病（n = 17）的受试者。我们还使用了哈恰图良和CERAD标准。在6微米厚的改良bielschowsky染色石蜡切片上评估来自内嗅-鼻周皮层、海马CA1和新皮层（包括下颞叶皮层、视觉关联皮层和初级视觉皮层）的神经原纤维缠结和神经纤维线密度。每个病例被分配到一个布拉克和布拉克阶段。使用NIA-Reagan标准，我们发现阿尔茨海默病痴呆的临床病史与大脑分配到阿尔茨海默病高可能性类别之间非常吻合。在神经病理学诊断为其他退行性疾病的大脑中，MA-Reagan标准比以前的标准更保守，这些病例可能被归类为中度或低可能性痴呆是由AD引起的。所有大脑前部无痴呆的受试者被划分为低（81%）或中（19%）类别。综上所述，我们发现NIA-Reagan标准与临床痴呆之间存在良好的相关性，这些标准与现有的神经病理学方法、Khachaturian和CERAD之间普遍存在良好的一致性。诊断AD在研究其他几种神经退行性疾病时，如与AD有神经病理和临床重叠的DLB，神经原纤维变化的分期提供了潜在的诊断改进。
The Khachaturian criteria and the Consortium to Establish a Registry for Alzheimer Disease (CERAD) criteria for the neuropathological assessment of Alzheimer disease (AD) emphasize sl:nile or neuritic plaques, age, and clinical history. A new scheme stressing topographic staging of neurofibrillary changes in addition to neuritic plaques has been proposed by the National Institute on Aging (NIA)-Reagan Institute Consensus Conference. This scheme assigns cases to high, intermediate, or low likelihood categories that the dementia is due to AD. We applied this method to 84 brains from subjects with clinical and neuropathological diagnoses of AD (n = 33), non-AD dementing illnesses (n = 34), including dementia with Lewy bodies (DLB) and progressive supranuclear palsy (PSP), and no neurological disease (n = 17). We also used Khachaturian and CERAD criteria. Neurofibrillary tangle and neuropil thread densities were assessed on 6-micrometer-thick modified Bielschowsky-stained paraffin sections from entorhinal-perirhinal cortex, CA1 of hippocampus, and neocortex including inferior temporal, visual association, and primary visual cortices. Each case was assigned a Braak and Braak stage. Using the NIA-Reagan criteria, we found excellent agreement between clinical history of AD dementia and brains assigned to the high likelihood category that dementia was due to AD. Among brains diagnosed neuropathologically with other degenerative diseases, MA-Reagan criteria were more conservative than previous criteria, and these cases were Likely to be categorized as intermediate or low likelihood that dementia was due to AD. All brains front nondemented subjects were assigned to the low (81%) or intermediate (19%) categories. In summary, we found good correlation between the NIA-Reagan criteria and clinical dementia, and there was generally good agreement between these criteria and existing neuropathological methods, Khachaturian and CERAD. in diagnosing AD. In studying several other neurodegenerative diseases, such as DLB, which shows neuropathological and clinical overlap with AD, the staging of neurofibrillary changes offered potential diagnostic refinement.