CORE--NEUROPATHOLOGY

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The Neuropathology (NP) Core provides complete brain banking and neuropathology diagnostic services for the Pittsburgh ADRC. To assure harvesting of excellent quality tissues with short post-mortem times, autopsies are performed are performed on a 24 hour basis and the average post-mortem time over the past four years is approximately 4 hours. The brain is bisected sagittally at the time of autopsy. The right half is dissected and extensively sampled (frozen samples banking, the left half of the brain is fixed in 10% buffered formalin. After fixation the left hemi-brain is intensely sampled for NP diagnostic tests including H&E, Congo Red immunocytochemical (beta-A4 amyloid, tau, alpha-synuclein, and ubiquitin) and silver stains (Bielschowsky). Microscopic analysis of the left hemi-brain is performed according to current NIA- recommendations which includes staging of neurofibrillary tangle density (Braak staging) and follows CERAD protocols for sampling and semi- quantitation. Lewy Body pathology is described per the consensus criteria of McKeith et. al. The NP Core has recently initiated use of alpha- synuclein staining to assess for the presence of Lewy bodies. The brain bank is catalogued and correlated with NP diagnoses to make available well characterized tissues to ADRC and other investigators. Quarterly are issued to investigators to alert them to the availability and diagnoses of banked cases. Banked tissue samples are coded with a unique NP Core banking identifier which does not allow investigators to identify the patient, however, provides a link (through the rain bank which maintains the key on a secure pass-work linked file, with access only by NP Core personnel). Investigators are also provided with additional non- identifying information (age, sex, post-mortem time race, etc.) Tissues and data are made available to investigators only after review and approval by the ADRC Executive Committee and Dr. Wiley and requires IRB approval of the research protocol. NP diagnoses and a 2-3 page narrative report are supplied to the ADRC database and families within one month of death. As of 1998 the NP core banks approximately 50 ADRC autopsies per year. Additionally, control brains have been banked and characterized by identical protocols including microscopic neuropathologic evaluation. The core contains reference laboratory (including a Ar/Kr laser confocal microscope and Image 1 workstation) for development of detained and quantitative analyses.