Neurodegenerative Neuropathology
Neurodegenerative Neuropathology
What You'll Learn
- To classify neurodegeneration by the misfolded protein — tau, α-synuclein, TDP-43, polyQ, prion
- The signature inclusion, stain, and regional atrophy for each disease
- How to separate the overlapping dementias and parkinsonisms on tissue
The neuropathology view — inclusions, stains, distribution. Clinical diagnosis/treatment lives in the Dementia and Movement Disorders notes.
What You'll Learn
| Disease | Pathology | Stain / distribution |
|---|---|---|
| Alzheimer | Neuritic Aβ plaques + neurofibrillary tangles (paired helical tau); neuropil threads; granulovacuolar degeneration & Hirano bodies (hippocampus); CAA | Bielschowsky/thioflavin/Aβ IHC; tau IHC; Braak tangle + Thal amyloid staging; hippocampal & temporoparietal atrophy |
| PSP | Globose tangles, tufted astrocytes, coiled bodies; midbrain/pallidum/subthalamic | 4R-tau; midbrain atrophy (“hummingbird”) |
| Corticobasal degeneration | Astrocytic plaques, ballooned achromatic neurons; asymmetric frontoparietal | 4R-tau |
| Pick disease (FTLD-tau) | Pick bodies (round argyrophilic), ballooned Pick cells; knife-edge frontotemporal atrophy | 3R-tau; silver+ |
What You'll Learn
| Disease | Pathology | Clue |
|---|---|---|
| Parkinson disease | Nigral Lewy bodies (eosinophilic, halo) & Lewy neurites; loss of pigmented dopaminergic neurons | Depigmented substantia nigra; α-synuclein+; Braak PD staging (ascending) |
| Dementia with Lewy bodies | Limbic + neocortical Lewy bodies/neurites (cortical LBs less distinct) | α-synuclein IHC required to see cortical LBs |
| Multiple system atrophy | Glial cytoplasmic inclusions (Papp-Lantos bodies) in oligodendrocytes; striatonigral & olivopontocerebellar degeneration | α-synuclein+; putaminal/pontine (“hot cross bun”) atrophy |
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