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Review
. 2010 Sep;56(9):484-546.
doi: 10.1016/j.disamonth.2010.06.001.

Alzheimer disease

Rudy J Castellani, Raj K Rolston, Mark A Smith
Review

Alzheimer disease

Rudy J Castellani et al. Dis Mon. 2010 Sep.
No abstract available

PubMed Disclaimer

Figures

Figure 1
Figure 1
Cored “miliary focus” is demonstrated in this Bielshowsky silver impregnation, the technique that Alzheimer used in his original description of Auguste D. Such foci were known to occur in association with “dementia senilis” prior to Alzheimer’s description.
Figure 2
Figure 2
Neurofibrillary tangles, as seen on the Bielshowsky silver stain, were initially characterized by Alzheimer.
Figure 3
Figure 3
Immunohistochemical stain for phosphorylated tau (monoclonal antibody AT8 which recognizes phosphorylation at residues 202 and 205) shows numerous distended neurites in a classic neuritic plaque. Tau immunohistochemistry is the best indicator of a neuritic plaque, although CERAD recommended Bielschowsky silver impregnation (which detects multiple plaque subtypes) to assess neuritic plaque frequency.
Figure 4
Figure 4
Gross brain of a 73 year old patient with Braak stage IV AD who was ambulatory but demented at the time of death. Note the generalized atrophy, ventricular dilatation (“hydrocephalus ex vacuo”), and medial temporal atrophy as well.
Figure 5
Figure 5
Close up view of the hippocampal formation of the same patient as in Figure 4, showing dilatation of the temporal horn and hippocampal atrophy. An atherosclerotic plaque involving the posterior cerebral artery is also present.
Figure 6
Figure 6
Synapse by electron microscopy. Note the presynaptic vesicles and the dense junctional complex. Assessment of the synapse in neurodegenerative disease is strictly investigational, and has no role in the neuropathological diagnosis.
Figure 7
Figure 7
Congo red stain for generic amyloid highlights senile plaques in a case of AD, although in general Congo red staining is far less sensitive and Bielschowsky silver staining or Aβ immunohistochemistry.
Figure 8
Figure 8
Diffuse plaques in the cerebral cortex with Aβ (4G8) immunohistochemistry.
Figure 9
Figure 9
H&E stained section of a cored, neuritic plaque. Note the presence of activated microglia to left and below the amyloid core.
Figure 10
Figure 10
Immunohistochemical stain for tau (AT8) showing a neurofibrillary tangle. Note the neuropil threads in the background.
Figure 11
Figure 11
Immunohistochemical stain for Aβ in an individual who died of complications of lobar intracerebral hemorrhage. The patient was living independent with no evidence of cognitive dysfunction prior to death.
Figure 12
Figure 12
H&E stained section of the hippocampus showing a Hirano body in the perikaryon of a pyramidal neuron.
Figure 13
Figure 13
H&E stained section of hippocampus showing granulovacuolar degeneration affecting a pyramidal neuron. A Hirano body is also present.
See this image and copyright information in PMC

References

    1. Alzheimer A. Uber eine eigenartige Erkrankung der Hirnrinde. Allgemeine Zeits Psychiat PsychischYGerichtlich Med. 1907;64:146–148.
    1. Roth M, Tomlinson BE, Blessed G. Correlation between scores for dementia and counts of 'senile plaques' in cerebral grey matter of elderly subjects. Nature. 1966;209:109–110. - PubMed
    1. Roth M, Tomlinson BE, Blessed G. The relationship between quantitative measures of dementia and of degenerative changes in the cerebral grey matter of elderly subjects. Proc R Soc Med. 1967;60:254–260. - PMC - PubMed
    1. Tomlinson BE, Blessed G, Roth M. Observations on the brains of demented old people. J Neurol Sci. 1970;11:205–242. - PubMed
    1. Berrios G. Alzheimer's disease: A conceptual history. International Journal of Geriatric Psychiatry. 1990;5:355–365.

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